上消化道出血病因分析的单中心回顾性研究
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摘要
目的研究上消化道出血的病因及不同年龄段患者病因构成比情况。方法回顾性分析2012年1月至2018年1月于首都医科大学附属北京友谊医院诊断上消化道出血并行胃镜检查的住院患者的临床资料,包括性别、年龄、住院天数、胃镜检查结果及是否镜下治疗、是否入住重症监护室、是否输血及院内死亡等;并按年龄分组对上消化道出血病因构成比进行分析。结果共有525例住院患者因上消化道出血行胃镜检查,胃镜结果提示上消化道出血的前三位病因分别为胃十二指肠溃疡出血、胃恶性肿瘤及食管胃底静脉曲张破裂出血;消化性溃疡是各个年龄段的首要病因,随着年龄增长,胃恶性肿瘤所致的上消化道出血比率逐渐升高。结论消化性溃疡始终是各个年龄段患者上消化道出血的首要原因,胃恶性肿瘤导致上消化道出血比率随年龄增长而增加。
Objective To study the etiology of upper gastrointestinal bleeding and to analyze the ratio of different etiologies according to age groups. Methods Collected inpatients who coincided clinical diagnosis of upper gastrointestinal bleeding and etiological diagnosis by endoscopy between January 2012 and January 2018 at Beijing Friendship Hospital,Capital Medical University. Clinical information,which includes gender,age,duration of hospitalization,endoscopy and endoscopic therapy,stay in ICU,blood transfusion and hospital mortality and all the data were collected and retrospectively analyzed. And the ratio of upper gastrointestinal bleeding according to age groups was investigated. Results525 subjects were examined by gastroscopy. Results showed that the top 3 causes of bleeding were peptic ulcer,gastric malignant tumor and esophageal gastric varices. Peptic ulcer was the main cause in all of age groups. The proportion of upper gastrointestinal bleeding which caused by gastric tumor increae with age. Conclusion Peptic ulcer was the primary cause of upper gastrointestinal bleeding in all ages,the proportion of gastric tumor increases with age.
Objective To study the etiology of upper gastrointestinal bleeding and to analyze the ratio of different etiologies according to age groups. Methods Collected inpatients who coincided clinical diagnosis of upper gastrointestinal bleeding and etiological diagnosis by endoscopy between January 2012 and January 2018 at Beijing Friendship Hospital,Capital Medical University. Clinical information,which includes gender,age,duration of hospitalization,endoscopy and endoscopic therapy,stay in ICU,blood transfusion and hospital mortality and all the data were collected and retrospectively analyzed. And the ratio of upper gastrointestinal bleeding according to age groups was investigated. Results525 subjects were examined by gastroscopy. Results showed that the top 3 causes of bleeding were peptic ulcer,gastric malignant tumor and esophageal gastric varices. Peptic ulcer was the main cause in all of age groups. The proportion of upper gastrointestinal bleeding which caused by gastric tumor increae with age. Conclusion Peptic ulcer was the primary cause of upper gastrointestinal bleeding in all ages,the proportion of gastric tumor increases with age.
引文
[1]Budimir I,Stojsavljevi!c S,Hrabar D,et al.Bleeding Peptic UlcerTertiary Center Experience:Epidemiology,Treatment and Prognosis.[J].Acta Clin Croat,2017,56(4):707-714.
[2]Minakari M,Badihian S,Jalalpour P,et al.Etiology and outcome in patients with upper gastrointestinal bleeding:Study on 4747 patients in the central region of Iran.[J].J Gastroenterol Hepatol,2017,32(4):789-796.
[3]Thiebaud PC,Yordanov Y,Galimard JE,et al.Management of upper gastrointestinal bleeding in emergency departments,from bleeding symptoms to diagnosis:a prospective,multicenter,observational study[J].Scand J Trauma Resusc Emerg Med,2017,25(1):78.
[4]Lahiff C,Shields W,Cretu I,et al.Upper gastrointestinal bleeding:predictors of risk in a mixed patient group including variceal and nonvariceal haemorrhage[J].Eur J Gastroenterol Hepatol,2012,24(2):149-154.
[5]索宝军,周丽雅,丁士刚,等.急性消化道出血的病因及其相关因素分析[J].中华医学杂志,2011,91(25):1757-1761.
[6]王海燕,顿晓熠,柏愚,等.中国上消化道出血的临床流行病学分析[J].中华消化内镜杂志,2013,30(2):83-86.
[7]陈良言.上消化道出血病因与相关因素分析[J].临床和实验医学杂志,2009,8(5):51-52.
[8]Peleteiro B,Bastos A,Ferro A,et al.Prevalence of Helicobacter pylori infection worldwide:a systematic review of studies with national coverage[J].Dig Dis Sci,2014,59(8):1698-1709.
[9]张万岱,胡伏莲,萧树东,等.中国自然人群幽门螺杆菌感染的流行病学调查[J].现代消化及介入诊疗,2010,15(5):265-270.
[10]杜春,苏秉忠.上消化道出血病因及相关因素临床分析[J].内蒙古医学院学报,2010,32(5):464-467.
[11]宋慧东,陈沅然,罗国彪,等.我院近3年肝硬化并发上消化道出血的回顾性研究[J].肝脏,2017,22(1):41-44.
[12]Baxter M,Aly EH.Dieulafoy's lesion:current trends in diagnosis and management[J].Ann R Coll Surg Engl,2010,92(7):548-554.
[13]李征波,黎培员,何理,等.食管贲门黏膜撕裂综合征诊治64例临床体会[J].世界华人消化杂志,2015,23(5):772-776.
[14]娄重阳,李德宇,王连才,等.食管-贲门黏膜撕裂综合征诊断与治疗[J].中华实用诊断与治疗杂志,2016,30(6):604-605.
[15]Ohmann C,Imhof M,Ruppert C,et al.Time-trends in the epidemiology of peptic ulcer bleeding[J].Scand J Gastroenterol,2005,40(8):914-920.
[16]González-González JA,Monreal-Robles R,García-Compean D,et al.Nonvariceal upper gastrointestinal bleeding in elderly people:Clinical outcomes and prognostic factors.[J].J Dig Dis,2017,18(4):212-221.
[17]Loperfido S,Baldo V,Piovesana E,et al.Changing trends in acute upper-GI bleeding:a population-based study[J].Gastrointest Endosc,2009,70(2):212-224.
[18]Nahon S,Pariente A,Faroux R,et al.Prognosis of upper gastrointestinal bleeding in the oldest-old patients:a post hoc analysis of a prospective study[J].J Am Geriatr Soc,2010,58(5):989-990.
[19]Na YJ,Shim KN,Kang MJ,et al.Comparison of clinical characteristics and outcomes between geriatric and non-geriatric patients in peptic ulcer bleeding[J].Korean J Gastroenterol,2009,53(5):297-304.
[20]Lim JH,Lee DH,Shin CM,et al.Clinicopathological features and surgical safety of gastric cancer in elderly patients.[J].J Korean Med Sci,2014,29(12):1639-1645.
[21]沈雯雯,张玫,和芳.北京部分地区10年中青年和老年上消化道出血病因流行病学分析及经济负担研究[J].中国临床医生杂志,2018,46(12):1402-1406.
[2]Minakari M,Badihian S,Jalalpour P,et al.Etiology and outcome in patients with upper gastrointestinal bleeding:Study on 4747 patients in the central region of Iran.[J].J Gastroenterol Hepatol,2017,32(4):789-796.
[3]Thiebaud PC,Yordanov Y,Galimard JE,et al.Management of upper gastrointestinal bleeding in emergency departments,from bleeding symptoms to diagnosis:a prospective,multicenter,observational study[J].Scand J Trauma Resusc Emerg Med,2017,25(1):78.
[4]Lahiff C,Shields W,Cretu I,et al.Upper gastrointestinal bleeding:predictors of risk in a mixed patient group including variceal and nonvariceal haemorrhage[J].Eur J Gastroenterol Hepatol,2012,24(2):149-154.
[5]索宝军,周丽雅,丁士刚,等.急性消化道出血的病因及其相关因素分析[J].中华医学杂志,2011,91(25):1757-1761.
[6]王海燕,顿晓熠,柏愚,等.中国上消化道出血的临床流行病学分析[J].中华消化内镜杂志,2013,30(2):83-86.
[7]陈良言.上消化道出血病因与相关因素分析[J].临床和实验医学杂志,2009,8(5):51-52.
[8]Peleteiro B,Bastos A,Ferro A,et al.Prevalence of Helicobacter pylori infection worldwide:a systematic review of studies with national coverage[J].Dig Dis Sci,2014,59(8):1698-1709.
[9]张万岱,胡伏莲,萧树东,等.中国自然人群幽门螺杆菌感染的流行病学调查[J].现代消化及介入诊疗,2010,15(5):265-270.
[10]杜春,苏秉忠.上消化道出血病因及相关因素临床分析[J].内蒙古医学院学报,2010,32(5):464-467.
[11]宋慧东,陈沅然,罗国彪,等.我院近3年肝硬化并发上消化道出血的回顾性研究[J].肝脏,2017,22(1):41-44.
[12]Baxter M,Aly EH.Dieulafoy's lesion:current trends in diagnosis and management[J].Ann R Coll Surg Engl,2010,92(7):548-554.
[13]李征波,黎培员,何理,等.食管贲门黏膜撕裂综合征诊治64例临床体会[J].世界华人消化杂志,2015,23(5):772-776.
[14]娄重阳,李德宇,王连才,等.食管-贲门黏膜撕裂综合征诊断与治疗[J].中华实用诊断与治疗杂志,2016,30(6):604-605.
[15]Ohmann C,Imhof M,Ruppert C,et al.Time-trends in the epidemiology of peptic ulcer bleeding[J].Scand J Gastroenterol,2005,40(8):914-920.
[16]González-González JA,Monreal-Robles R,García-Compean D,et al.Nonvariceal upper gastrointestinal bleeding in elderly people:Clinical outcomes and prognostic factors.[J].J Dig Dis,2017,18(4):212-221.
[17]Loperfido S,Baldo V,Piovesana E,et al.Changing trends in acute upper-GI bleeding:a population-based study[J].Gastrointest Endosc,2009,70(2):212-224.
[18]Nahon S,Pariente A,Faroux R,et al.Prognosis of upper gastrointestinal bleeding in the oldest-old patients:a post hoc analysis of a prospective study[J].J Am Geriatr Soc,2010,58(5):989-990.
[19]Na YJ,Shim KN,Kang MJ,et al.Comparison of clinical characteristics and outcomes between geriatric and non-geriatric patients in peptic ulcer bleeding[J].Korean J Gastroenterol,2009,53(5):297-304.
[20]Lim JH,Lee DH,Shin CM,et al.Clinicopathological features and surgical safety of gastric cancer in elderly patients.[J].J Korean Med Sci,2014,29(12):1639-1645.
[21]沈雯雯,张玫,和芳.北京部分地区10年中青年和老年上消化道出血病因流行病学分析及经济负担研究[J].中国临床医生杂志,2018,46(12):1402-1406.
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