【摘要】：目的:回顧性分析2009年至2014年吉林大學(xué)第二醫(yī)院收治的上消化道出血患者的病因構(gòu)成及其與年齡、性別、季節(jié)的關(guān)系,觀(guān)察6年間其變化規(guī)律,為更好了解本地區(qū)近年來(lái)上消化道出血發(fā)病現(xiàn)狀和病種變遷,加強(qiáng)臨床工作中醫(yī)生對(duì)于上消化道出血的了解,以此指導(dǎo)臨床醫(yī)生對(duì)上消化道出血病因快速、準(zhǔn)確地做出判斷及制定合理的臨床干預(yù)措施,以提高預(yù)后,降低病死率,并有利于對(duì)患者進(jìn)行健康教育,降低發(fā)病率及復(fù)發(fā)率。方法:本研究收集吉林大學(xué)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(jì)2532例,經(jīng)納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)進(jìn)行篩選后,進(jìn)入本研究的患者共計(jì)1510例,統(tǒng)計(jì)患者病因、年齡、性別、發(fā)病時(shí)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(dǎo)致患者上消化道出血的常見(jiàn)病因在6年間的變化規(guī)律及其與性別、年齡、季節(jié)的關(guān)系。所有數(shù)據(jù)資料均采用SPSS18.0統(tǒng)計(jì)軟件進(jìn)行分析處理,樣本率的比較采用X2檢驗(yàn),P0.05認(rèn)為有統(tǒng)計(jì)學(xué)意義,以P0.01定義為具有顯著統(tǒng)計(jì)學(xué)差異。結(jié)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(wú)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(jì)學(xué)意義。5.本研究中糜爛性食管炎發(fā)病率呈逐年下降趨勢(shì)。另外其他原因(如血管性疾病、血液病、尿毒癥等)的趨勢(shì)卡方檢驗(yàn)c2=45.749,p=0.0000.05,具有統(tǒng)計(jì)學(xué)意義,說(shuō)明其他原因發(fā)病率呈逐年上升趨勢(shì)。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(shì),而青年組發(fā)病比例呈逐年下降的趨勢(shì)。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(jié)論:對(duì)以長(zhǎng)春市吉林大學(xué)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?yàn)槭改c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(dǎo)致上消化道出血者以男性為主,急性胃黏膜病變導(dǎo)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(shì),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(shì)。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?yàn)槲笣儭?br/>[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(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R573.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙玉山;溫樹(shù)偉;暢俊平;張曉前;黨之俊;;介入診斷和栓塞治療在消化道出血中的應(yīng)用價(jià)值[J];世界華人消化雜志;2016年03期

2 ;急性上消化道出血急診診治流程專(zhuān)家共識(shí)[J];中國(guó)急救醫(yī)學(xué);2015年10期

3 周光文;楊連粵;;肝硬化門(mén)靜脈高壓癥食管、胃底靜脈曲張破裂出血診治專(zhuān)家共識(shí)(2015)[J];中國(guó)實(shí)用外科雜志;2015年10期

4 何貴陽(yáng);;上消化道出血340例病因和臨床特點(diǎn)分析[J];中國(guó)社區(qū)醫(yī)師;2015年27期

5 王麗敏;傅文安;秦月花;張曉蘋(píng);吳軍霞;;不同原發(fā)病抗血小板藥物導(dǎo)致上消化道出血的特點(diǎn)[J];中國(guó)老年學(xué)雜志;2015年18期

6 湯炳;;肝硬化合并上消化道出血的臨床治療效果分析[J];肝膽外科雜志;2015年04期

7 邱偉偉;陳建榮;;急性上消化道出血病程中尿素氮變化的臨床分析[J];中國(guó)醫(yī)刊;2015年08期

8 朱嬋艷;曹海霞;段曉燕;王曉穎;許朝陽(yáng);顏士巖;陳梅梅;陳一銘;范建高;;原發(fā)性肝淀粉樣變性并消化道出血1例[J];中華肝臟病雜志;2015年06期

9 劉健;韓佰花;李玉琴;唐彤宇;;上消化道出血與季節(jié)變化及氣象因素的相關(guān)性研究[J];中華臨床醫(yī)師雜志(電子版);2015年04期

10 柳勛法;劉莉;鐘源波;龍連宮;;急診保守治療與急診胃鏡治療上消化道出血的臨床對(duì)比研究[J];醫(yī)學(xué)綜述;2013年23期

，

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