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目的研究老年人上消化道出血的病因及临床表现。方法回顾分析我院2008年1月至2010年1月间收治的老年人上消化道出血146例的临床及内镜特点,并与同期中青年病例比较。结果本组老年人上消化道出血的病因为胃溃疡48例,十二指肠溃疡27例,食管胃底静脉曲张破裂出血18例,复合溃疡12例,胃癌26例,急性胃黏膜病变13例。老年组复合溃疡、胃溃疡、肿瘤高于非老年组(P<0.05),而十二指肠溃疡所占比例明显低于非老年组(P<0.05)。结论消化性溃疡是老年人上消化道出血的主要原因,其次为食管胃底静脉曲张破裂出血、胃癌、急性胃黏膜病变等。
Objective To study the etiology and clinical manifestations of upper gastrointestinal bleeding in the elderly. Methods The clinical and endoscopic features of 146 cases of upper gastrointestinal bleeding admitted to our hospital from January 2008 to January 2010 were retrospectively analyzed and compared with the cases of middle-aged and young people in the same period. Results The causes of upper gastrointestinal bleeding in this group were gastric ulcer in 48 cases, duodenal ulcer in 27 cases, esophageal variceal bleeding in 18 cases, complex ulcer in 12 cases, gastric carcinoma in 26 cases, acute gastric mucosal lesions in 13 cases . The elderly patients with complex ulcer, gastric ulcer and tumor were higher than those in non-elderly group (P <0.05), while the proportion of duodenal ulcer was significantly lower than that in non-elderly group (P <0.05). Conclusion Peptic ulcer is the main cause of upper gastrointestinal bleeding in the elderly, followed by esophageal and gastric variceal bleeding, gastric cancer and acute gastric mucosal lesions.