| 卞 卡,张巍巍.老年胃溃疡出血患者再发出血的危险因素分析[J].中国烧伤创疡杂志,2024,(1):62~65. |
| DOI： |
| 中文关键词: 胃溃疡出血 老年 再出血 消化内镜治疗 幽门螺杆菌 非甾体抗炎药 危险因素 |
| 英文关键词:Gastric ulcer hemorrhage Elderly Rebleeding Digestive endoscopic treatment Helicobacter pylori Nonsteroidal anti-inflammatory drugs Risk factors |
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| 中文摘要: |
| 【摘要】 目的 探讨分析老年胃溃疡出血患者再发出血的相关危险因素。方法 选取 2020 年3月至2022年3月许昌市中心医院收治的 140 例老年胃溃疡出血患者作为研究对象, 收集患者性别、年龄、发病部位、胃溃疡长径、出血活动度、是否为胃溃疡 A1 期、是否合并幽门螺杆菌 (Hp) 感染、有无吸烟史、有无饮酒史、合并其他慢性疾病种类 (≤2 种、>2 种)、是否进行消化内镜治疗、是否长期使用非甾体抗炎药 (NSAIDs) 等资料,并根据患者止血成功后 1 个月内是否再发出血将患者分为发生组与未发生组? 多因素 Logistic 回归分析老年胃溃疡出血患者再发出血的危险因素。结果 140 例老年胃溃疡出血患者均于止血成功后随访 1 个月, 随访过程中 21例 (15.0%) 患者再发出血, 设为发生组; 119 例 (85.0%) 患者未再发出血, 设为未发生组。单因素分析结果显示, 发生组胃溃疡 A1 期、Hp 感染、未进行消化内镜治疗、长期使用 NSAIDs 的患者比例均明显高于未发生组(χ2 = 4.269、7.381、7.580、11.836, P= 0.039、0.007、0.006、0.001); 多因素 Logistic 回归分析结果显示, 胃溃疡 A1 期、Hp 感染、未进行消化内镜治疗、长期使用 NSAIDs 是老年胃溃疡出血患者再发出血的独立危险因素(95%CI 为 1.039~ 9.660、1.909~ 58.707、0.059~ 0.585、1.880~ 18.559, P= 0.043、0.007、0.004、0.002)。 结论 胃溃疡 A1 期、Hp 感染、未进行消化内镜治疗、长期使用 NSAIDs 是老年胃溃疡出血患者再发出血的独立危险因素, 临床应根据患者具体情况制定针对性干预措施, 以降低再出血发生风险。 |
| 英文摘要: |
| 【Abstract】 Objective To study risk factors for rebleeding of gastric ulcer hemorrhage in the elderly patients.Methods 140 elderly patients with gastric ulcer hemorrhage, admitted to Xuchang Central Hospital from March 2020 to March 2022, were selected as research subjects, and the following data of patients were collected, including sex, age, site of ulcer, gastric ulcer long diameter, bleeding activity, stage A1 gastric ulcer, Helicobacter pylori (Hp) infection, history of smoking and drinking, number of other types of chronic diseases (≤2 types, >2 types), digestive endoscopic treatment, and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). These patients were divided into the occurrence group and non-occurrence group based on whether rebleeding occurred within one month after successful hemostasis. Multivariate Logistic regression analysis was conducted to identify the risk factors for rebleeding of gastric ulcer bleeding in the elderly patients. Results All the 140 elderly patients with gastric ulcer hemorrhage were followed up for one month after hemostasis. During the follow-up, 21 patients (15.0%) who experienced rebleeding were set as the occurrence group, while 119 patients (85.0%) who did not suffer rebleeding were set as the non-occurrence group. Results of the univariate analysis showed that patients with stage A1 gastric ulcers, Hp infection, free of digestive endoscopic treatment, and long-term use of NSAIDs had notably higher proportions in the occurrence group compared with the non-occurrence group ( χ2 = 4.269,7.381, 7.580 and 11.836, P= 0.039, 0.007, 0.006 and 0.001). The multivariate Logistic regression analysis found that stage A1 gastric ulcer, Hp infection, free of digestive endoscopic treatment, and long-term use of NSAIDs were independent risk factors for rebleeding of gastric ulcer hemorrhage in the elderly patients ( 95% CI: 1.039 - 9.660, 1.909 - 58.707, 0.059-0.585 and 1.880-18.559, P= 0.043, 0.007, 0.004 and 0.002). Conclusion Stage A1 gastric ulcer, Hp infection, free of digestive endoscopic treatment, and long-term use of NSAIDs are independent risk factors for rebleeding of gastric ulcer hemorrhage in the elderly patients. Clinically, tailored interventions should be formulated based on individual patient’s conditions to reduce the risk of rebleeding. |
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