上消化道出血的病因及相關因素分析
發(fā)布時間：2018-09-11 09:42
【摘要】：目的:回顧性分析2009年至2014年吉林大學第二醫(yī)院收治的上消化道出血患者的病因構成及其與年齡、性別、季節(jié)的關系,觀察6年間其變化規(guī)律,為更好了解本地區(qū)近年來上消化道出血發(fā)病現(xiàn)狀和病種變遷,加強臨床工作中醫(yī)生對于上消化道出血的了解,以此指導臨床醫(yī)生對上消化道出血病因快速、準確地做出判斷及制定合理的臨床干預措施,以提高預后,降低病死率,并有利于對患者進行健康教育,降低發(fā)病率及復發(fā)率。方法:本研究收集吉林大學第二醫(yī)院2009年1月至2014年12月住院的上消化道出血患者的臨床資料,共計2532例,經納入標準、排除標準進行篩選后,進入本研究的患者共計1510例,統(tǒng)計患者病因、年齡、性別、發(fā)病時間、病死率、檢查方法等。建立完善的上消化道出血病例資料登記表并逐一記錄,整理歸納各變量特征。并分析導致患者上消化道出血的常見病因在6年間的變化規(guī)律及其與性別、年齡、季節(jié)的關系。所有數(shù)據(jù)資料均采用SPSS18.0統(tǒng)計軟件進行分析處理,樣本率的比較采用X2檢驗,P0.05認為有統(tǒng)計學意義,以P0.01定義為具有顯著統(tǒng)計學差異。結果:本研究中:1.本組患者上消化道出血病因前5位依次為十二指腸潰瘍、胃潰瘍、食管胃底靜脈曲張破裂、急性胃黏膜病變、胃癌。2.男性患者多于女性,男性年齡明顯小于女性(P0.01),胃潰瘍、食管胃底靜脈曲張破裂和胃癌患者的男女比例無明顯差異(P0.05),而十二指腸潰瘍以男性為主(P0.05),急性胃黏膜病變以女性為主(P0.05)。3.特征性臨床表現(xiàn)以黑便為主。4.患者住院期間男性因食管胃底靜脈曲張破裂的死亡率高于女性(p0.05),差異有統(tǒng)計學意義。5.本研究中糜爛性食管炎發(fā)病率呈逐年下降趨勢。另外其他原因(如血管性疾病、血液病、尿毒癥等)的趨勢卡方檢驗c2=45.749,p=0.0000.05,具有統(tǒng)計學意義,說明其他原因發(fā)病率呈逐年上升趨勢。6.上消化道出血患者2009至2014年老年組發(fā)病比例呈逐年上升的趨勢,而青年組發(fā)病比例呈逐年下降的趨勢。7.十二指腸潰瘍的發(fā)病率青年組最高,其次為中年組,老年組最低(p0.05);胃潰瘍的發(fā)病率青年組最低(p0.05);食管胃底靜脈曲張破裂的發(fā)病率中年組最高(p0.05);胃癌的發(fā)病率老年組最高(p0.05)。8.在不同季節(jié)中,胃潰瘍的發(fā)病率春季和冬季要低于夏季和秋季(p0.05);食管胃底靜脈曲張破裂的發(fā)病率冬季最高(p0.05);急性胃黏膜病變的發(fā)病率春季要高于夏季和冬季(p0.05);胃癌的發(fā)病率夏季最低(p0.05)。結論:對以長春市吉林大學第二醫(yī)院為中心的周邊區(qū)域6年間收治的1510例上消化道出血患者的分析表明:1.主要病因為十二指腸潰瘍、胃潰瘍、食管靜脈曲張破裂、急性胃黏膜病變、胃癌。2.十二指腸潰瘍導致上消化道出血者以男性為主,急性胃黏膜病變導致上消化道出血者以以女性為主。3.老年組上消化道出血發(fā)病比例呈逐年上升的趨勢,最主要出血病因是胃潰瘍,青年組發(fā)病比例呈逐年下降趨勢。4.春季、夏季和冬季均以十二指腸潰瘍?yōu)樽钪饕鲅∫?秋季最主要出血病因為胃潰瘍。
[Abstract]:Objective:To retrospectively analyze the etiological components of upper gastrointestinal hemorrhage patients admitted to the Second Hospital of Jilin University from 2009 to 2014 and their relationship with age,sex and season. To understand the causes of upper gastrointestinal hemorrhage, guide clinicians to quickly and accurately determine the causes of upper gastrointestinal hemorrhage and formulate reasonable clinical intervention measures to improve prognosis, reduce mortality, and help patients with health education, reduce the incidence and recurrence rate. The clinical data of 2532 patients with upper gastrointestinal hemorrhage admitted to the hospital in December, 2014 were analyzed. After inclusion criteria and exclusion criteria were selected, 1510 patients were enrolled in the study. The etiology, age, sex, onset time, mortality and examination methods of the patients were analyzed. All data were analyzed by SPSS18.0 statistical software. The sample rate was compared by X2 test, P 0.05 was considered statistically significant, and P 0.01 was defined as having statistical significance. Results: 1. The top five causes of upper gastrointestinal bleeding in this group were duodenal ulcer, gastric ulcer, rupture of esophageal and gastric varices, acute gastric mucosal lesions, gastric cancer. 2. Male patients were more than females, and male patients were significantly younger than females (P 0.01), gastric ulcer, rupture of esophageal and gastric varices and gastric cancer. There was no significant difference between male and female (P 0.05), while duodenal ulcer was predominant in male (P 0.05), and acute gastric mucosal lesion was predominant in female (P 0.05). 3. The characteristic clinical manifestation was mainly black stool. 4. The mortality of male patients with esophagogastric varices rupture was higher than that of female patients during hospitalization (P 0.05). The incidence of middle erosive esophagitis showed a decreasing trend year by year. Other causes (such as vascular diseases, blood diseases, uremia, etc.) trend Chi-square test C2 = 45.749, P = 0.0000.05, statistically significant, indicating that the incidence of other causes showed an increasing trend year by year. 6. Upper gastrointestinal bleeding in 2009 to 2014, the incidence of elderly patients showed a rising trend year by year. The incidence of duodenal ulcer was the highest in the youth group, followed by the middle-aged group, the lowest in the elderly group (p0.05); the incidence of gastric ulcer was the lowest in the youth group (p0.05); the incidence of esophagogastric varices rupture was the highest in the middle-aged group (p0.05); the incidence of gastric cancer was the highest in the elderly group (p0.05); and the incidence of gastric cancer was the highest in the elderly group (p0.05). The incidence of gastric ulcer in spring and winter was lower than that in summer and autumn (p0.05); the incidence of esophagogastric varices rupture in winter was the highest (p0.05); the incidence of acute gastric mucosal lesions in spring was higher than that in summer and winter (p0.05); the incidence of gastric cancer in summer was the lowest (p0.05). Conclusion: Jilin is the largest City for Changchun. Analysis of 1510 patients with upper gastrointestinal bleeding admitted in the peripheral area of the Second Hospital during the past six years showed that: 1. The main causes were duodenal ulcer, gastric ulcer, rupture of esophageal varices, acute gastric mucosal lesions, gastric cancer. 2. Duodenal ulcer caused upper gastrointestinal bleeding was mainly male, acute gastric mucosal lesions caused by disappearance. The incidence of upper gastrointestinal hemorrhage in the elderly group showed an upward trend year by year. The main cause of bleeding was gastric ulcer. The incidence of gastric ulcer in the youth group showed a downward trend year by year. 4. Duodenal ulcer was the main cause of bleeding in spring, summer and winter, and gastric ulcer was the main cause of bleeding in autumn.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R573.2
本文編號：2236330
[Abstract]:Objective:To retrospectively analyze the etiological components of upper gastrointestinal hemorrhage patients admitted to the Second Hospital of Jilin University from 2009 to 2014 and their relationship with age,sex and season. To understand the causes of upper gastrointestinal hemorrhage, guide clinicians to quickly and accurately determine the causes of upper gastrointestinal hemorrhage and formulate reasonable clinical intervention measures to improve prognosis, reduce mortality, and help patients with health education, reduce the incidence and recurrence rate. The clinical data of 2532 patients with upper gastrointestinal hemorrhage admitted to the hospital in December, 2014 were analyzed. After inclusion criteria and exclusion criteria were selected, 1510 patients were enrolled in the study. The etiology, age, sex, onset time, mortality and examination methods of the patients were analyzed. All data were analyzed by SPSS18.0 statistical software. The sample rate was compared by X2 test, P 0.05 was considered statistically significant, and P 0.01 was defined as having statistical significance. Results: 1. The top five causes of upper gastrointestinal bleeding in this group were duodenal ulcer, gastric ulcer, rupture of esophageal and gastric varices, acute gastric mucosal lesions, gastric cancer. 2. Male patients were more than females, and male patients were significantly younger than females (P 0.01), gastric ulcer, rupture of esophageal and gastric varices and gastric cancer. There was no significant difference between male and female (P 0.05), while duodenal ulcer was predominant in male (P 0.05), and acute gastric mucosal lesion was predominant in female (P 0.05). 3. The characteristic clinical manifestation was mainly black stool. 4. The mortality of male patients with esophagogastric varices rupture was higher than that of female patients during hospitalization (P 0.05). The incidence of middle erosive esophagitis showed a decreasing trend year by year. Other causes (such as vascular diseases, blood diseases, uremia, etc.) trend Chi-square test C2 = 45.749, P = 0.0000.05, statistically significant, indicating that the incidence of other causes showed an increasing trend year by year. 6. Upper gastrointestinal bleeding in 2009 to 2014, the incidence of elderly patients showed a rising trend year by year. The incidence of duodenal ulcer was the highest in the youth group, followed by the middle-aged group, the lowest in the elderly group (p0.05); the incidence of gastric ulcer was the lowest in the youth group (p0.05); the incidence of esophagogastric varices rupture was the highest in the middle-aged group (p0.05); the incidence of gastric cancer was the highest in the elderly group (p0.05); and the incidence of gastric cancer was the highest in the elderly group (p0.05). The incidence of gastric ulcer in spring and winter was lower than that in summer and autumn (p0.05); the incidence of esophagogastric varices rupture in winter was the highest (p0.05); the incidence of acute gastric mucosal lesions in spring was higher than that in summer and winter (p0.05); the incidence of gastric cancer in summer was the lowest (p0.05). Conclusion: Jilin is the largest City for Changchun. Analysis of 1510 patients with upper gastrointestinal bleeding admitted in the peripheral area of the Second Hospital during the past six years showed that: 1. The main causes were duodenal ulcer, gastric ulcer, rupture of esophageal varices, acute gastric mucosal lesions, gastric cancer. 2. Duodenal ulcer caused upper gastrointestinal bleeding was mainly male, acute gastric mucosal lesions caused by disappearance. The incidence of upper gastrointestinal hemorrhage in the elderly group showed an upward trend year by year. The main cause of bleeding was gastric ulcer. The incidence of gastric ulcer in the youth group showed a downward trend year by year. 4. Duodenal ulcer was the main cause of bleeding in spring, summer and winter, and gastric ulcer was the main cause of bleeding in autumn.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R573.2
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