摘要
目的探讨鄂西北地区近十年来上消化道出血（upper gastro intestinal bleeding，UGB）的病因及治疗方式的变化。方法分析2001～2010年鄂西北地区三家三甲医院确诊的1005例上消化道出血住院患者的临床资料。结果上消化道出血病因前五年构成比消化性溃疡、食管胃底静脉曲张、胃癌、急性胃黏膜病变、食管贲门粘膜撕裂综合征、糜烂性食管炎分别为51．1％、14．1％、6．6％、9．6％、3．5％、4．0％，后五年分别为29．9％、12．4％、17．5％、7．3％、2．2％、0．7％。消化性溃疡发病呈下降趋势，差异有显著性（χ2=42．146，P〈0．001）；胃癌发病呈上升趋势，差异有显著性（χ2=29．660，P〈0．001）。上消化道出血药物治疗、手术治疗和介入治疗前5年构成比分别为75．6％、17．7％、6．7％，后5年分别为74．5％、8．0％、17．5％；其中内镜下治疗前5年22．6％，后5年82．5％。介入治疗明显呈上升趋势，差异有显著性（χ2=29．660，P〈0．001）；手术治疗差异无统计学意义；内镜治疗明显增加，差异有显著性（χ2=350．111，P〈0．001）。结论近十年鄂西北上消化道出血的主要病因依旧为消化性溃疡、食管胃底静脉曲张、胃癌、急性胃黏膜病变；但消化性溃疡出血发病率明显降低，胃癌发病率略有增高。治疗方式依旧以药物治疗为主，介入治疗、内镜治疗病例明显增多。
Objective To investigate the causes and treatments of upper gastrointestinal bleeding （ UGB ） in northwest area of Hubei province during recent decade. Methods A retrospective analysis was carried out among 1005 cases from 2001 to 2010 on causes and clinical characteristics of UGB. Results The main causes of UGB were peptic ulcer（PU）, the stomach esophagus varicosity （EGV）, gastric cancer, acute gastric mucosal lesions （AGML）, cardiaoesophagus,mucosal tear syndrome and erosive esophagitis. In 2001 - 2005, of which the percentages were 55.1%, 14. 1%, 6. 6%, 9.6%, 3.5%, 4.0% respectively, and in 2006 -2010, of which the percentages were 29.9%, 17.5% , 12, 4% ,7.3% ,3.5% ,0.7% respectively. The percentage of PU decreased, and the difference was obvious （ χ2 = 42. 146, P 〈 0.001 ）. The percentage of stomach cancer increased, and the difference was obvious （ χ2 = 29. 660,P 〈 0.001 ）. With the endoscope, drug, surgery and intervention for UGB treatments , the average percenta- ges were 75.6% , 17.7% , 6, 7% respectively in 2001 - 2005, and were 74. 5% , 8% , 17.5% in 2006 - 2010. The percentage of endoscope therapy was 22.6% in.2001- 2005, and the percentage was 82.5% in 2006 - 2010. The percentage of intervention：therapy increased; and;the： difference was significant（ χ2 = 29. 660, P 〈 0. 001 ）. The differ- ence of surgery therapy was nor significant The pereeritage of endoscope therapy increased, and the difference was significant（ χ2 =350,111,P〈0.001 ）. Conclusion In nearly 10 years, the mare causes of UGB in northwest area of Hubei province were PU〈EVG,gastric Cancer and AGML. Erosive esophagitis decreases significantly as time goes, while EGV,AGML decrease Slightly. The main treatments of drug, interventional therapy and endoscopic therapy in- crease and surgical treatment decreases slightly.
出处
《医学新知》
CAS
2012年第6期405-406,410,共3页
New Medicine
基金
湖北医药学院科研立项基金（2011XS30）.
