摘要
目的探讨幽门螺杆菌(Hp)与消化性溃疡合并出血(PUB)的关系及PUB临床特点。方法回顾性分析233例PUB患者的一般情况、Hp感染及分型、服用非甾体类消炎药(NSAIDs)史、入院血红蛋白(Hb)值、临床症状及内镜特征、住院治疗情况等临床资料,根据Hp感染情况将PUB分为Hp(+)组164例和Hp(-)组69例,以同期非出血性消化性溃疡(PU)198例为对照组进行对比。结果 PUB组与对照组性别、年龄、Hp感染率差异无统计学意义(P>0.05)。PUB组Ⅰ型Hp阳性率83.5%高于对照组34.8%(P<0.01)。PUB中Hp(+)组消化道症状评分和腹痛比例均高于Hp(-)组(P<0.05),服用NSAIDs、Hb值、出血程度及内镜下Forrest分型差异无统计学意义(P>0.05)。233例PUB中有61例予输血治疗,Hp(-)组输血率高于Hp(+)组39.1%(27/69)vs 20.7%(34/164)(P<0.01),仅3例行外科手术治疗。Hp(-)组住院时间稍长于Hp(+)组(10.0±5.7)d vs(9.0±3.7)d,但差异无统计学意义(P>0.05)。结论 PU出血与Hp感染率无关,而与Hp分型有关。Hp(+)PUB消化道症状较重,而Hp(-)PUB输血率较高,且住院时间有延长趋势。PUB以内科治疗为主,手术率极低。
Objective To study the correlation of Helicobacter pylori（Hp） infection and peptic ulcer bleeding （PUB） ,and to study the clinical features of PUB. Methods Retrospective analysis was conducted on the clinical data of 233 patients with PUB such as general situation, Hp infection and type, nonsteroidal anti-inflammatory drugs（NSAIDs） history, admission hemoglobin（Hb） value, clinical symptoms and endoscopic features and hospital treatment. According to the Hp infection,the PUB patients were divided into Hp（＋） group （164 cases） and Hp（--） group（69 cases）,198 patients with non-bleeding peptic ulcer （PU） were selected randomly as control group. Results There were no statistical difference in gender, age, Hp infection rate between PUB group and control group （ P 〉 0.05）, in PUB group, I type Hp positive rate was 83.5% ,which was higher than that of the control group（34.8%） （ P 〈0.01）. In PUB Hp（ ＋ ） group,gastrointestinal symptoms score and abdominal pain ratio were higher than those in lip（- ） group （P 〈0.05）, NSAIDs use, Hb value, bleeding degree and endoscopic Forrest typing showed no statistical difference （P 〉 0.05）. Among 233 cases of PUB, 61 patients received blood transfusion treatment, the blood transfusion rate of Hp（- ） group was 39.1 % （27/69）, higher than that of the Hp （ ＋ ） group 20.7% （ 34/164 ） （ P 〈 0.01 ）, only 3 cases received surgical treatment. Hospitalization time of Hp（- ） group was slightly longer than that of Hp（ ＋ ） group, （10.0±5.7） d vs （9.0± 3.7） d,but it showed no statistical difference （ P 〉0.05）. Conclusion Hp infection rate has no correlation with PU bleeding. I type H p and PU hemorrhage are related. In PUB H p（＋）, gastrointestinal symptoms, abdominal pain are more serious, while in PUB Hp （-） group, blood transfusion rate is higher, length of hospital stay is prolonged. Medical treatment is given priority to PUB, the operation rate is extremely low.
出处
《临床荟萃》
CAS
2013年第2期175-177,共3页
Clinical Focus
