| 徐伟,朱曙光,张焰平.不同年龄组肝硬化合并上消化道出血 237例临床及内镜特点分析[J].安徽医药,2020,24(5):955-958. |
| 不同年龄组肝硬化合并上消化道出血 237例临床及内镜特点分析 |
| The clinical and endoscopic characteristics of patients in different age groups with cirrhosis and upper gastrointestinal bleeding |
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| DOI：10.3969/j.issn.1009?6469.2020.05.027 |
| 中文关键词: 肝硬化 胃肠出血 食管和胃静脉曲张 胃镜检查 |
| 英文关键词: Liver cirrhosis Gastrointestinal hemorrhage Esophageal and gastric varices Gastroscopy |
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| 中文摘要: |
| 目的分析不同年龄组肝硬化合并上消化道出血病人的临床和内镜特点。方法回顾分析 2014年 12月至 2018年 12月安徽医科大学附属安庆医院 237例肝硬化合并上消化道出血病人的临床及内镜资料，分为老年组( ≥60岁)和中青年组(＜ 60岁)分析不同年龄组的临床和内镜特点。结果老年组 114例，中青年组 123例，老年组男性比例( 47%)低于中青年组(81%)，，差异有统计学意义( χ2＝29.936，P＝0.001)。老年组具有休克症状的病人比例( 20.2%)低于中青年组( 34.1%)差异有统计学意义( χ2＝5.802，P＝0.016)。老年组病毒性肝炎后肝硬化、酒精性肝硬化比例( 34.2%、4.4%)低于中青年组(70，.7%、 10.6%)而血吸虫肝硬化比例( 44.7%)明显高于中青年组( 8.9%)，差异有统计学意义( χ2＝49.019，P＝0.001)。老年组合并两种及以础病的病人比例( 11.4%)高于中青年组( 0.8%)两组差异有统计学意义( χ2＝13.202，P＝0.001)。两组在食管静脉曲张起始部位分布方面差异有统计学意义( χ2＝8.668，P＝034)。老年组选择采用内镜下套扎联合硬化剂或组织胶注射治疗上基，0，的比例( 24.6%)低于中青年组( 39.8%)，差异有统计学意义( χ2＝10.852，P＝0.028)。结论不同年龄组肝硬化合并上消化道出血病人具有各自的临床及内镜特点，临床医生需结合不同病人的特点，进行快速、准确、有效的诊断和治疗。 |
| 英文摘要: |
| Objective To analyzed the clinical and endoscopic characteristics of patients in different age groups with cirrhosis andupper gastrointestinal bleeding.Methods The clinical and endoscopic data of 237 patients with liver cirrhosis complicated with up?per gastrointestinal bleeding in Anqing Hospital Affiliated to Anhui Medical University from December 2014 to December 2018were retrospectively analyzed，which were divided into the elderly group(≥60 years old)and the middle?aged and young group(＜ 60 years old).The clinical and endoscopic characteristics of different age groups were analyzed.Results There were 114 cases in the elderly group and 123 cases in the young and middle?aged group.The proportion of males in the elderly group(47%)was lower than that in the young and middle?aged group(81%)，with statistical difference(χ2＝29.936，P＝0.001).The proportion of patients with shock symptoms in the elderly group(20.2%)was lower than that in the young and middle?aged group(34.1%)，with statisti? cal difference(χ2＝5.802，P＝0.016).The proportion of cirrhosis after viral hepatitis and alcoholic cirrhosis in the elderly group(34.2%，4.4%)was lower than that in the young and middle?aged group(70.7%，10.6%)while the proportion of schistosomiasis cirrhosis(44.7%)was significantly higher than that in the young and middle?aged group(8.9%)，，and the difference was statistical? ly significant(χ2＝49.019，P＝0.001).The proportion of patients with two or more basic diseases in the elderly group(11.4%)was higher than that in the young and middle?aged group(0.8%)，and the two groups had statistical significance(χ2＝13.202，P＝0.001).There were statistical differences between the two groups in the distribution of the starting of esophageal varices(χ2＝8.668， P＝0.034).The cirrhosis patient treated with endoscopic sequential variceal 1igation plus sclerotherapy or endoscopic variceal liga?tion combined with gastric tissue glue injection in the elderly group(24.6%)was lower than in the young and middle?aged group(39.8%)(χ2＝10.852，P＝0.028).Conclusion The clinical and endoscopic characteristics of the patients with cirrhosis combinedwith upper gastrointestinal bleeding in different are groups are different.The clinicians are required to make rapid，accurate and ef? fective diagnosis and treatment in conjunction with the patient’s condition. |
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