目的 探讨老年人与非老年人上消化道出血在出血病因、并存疾病、临床特征及病死原因方面的差异.方法 回顾分析我院2009年1月～2011年12月收治的138例老年人上消化道出血和312例中青年上消化道出血的临床资料,对比老年人与中青年上消化道出血在出血病因、并存疾病、临床特征及病死原因等方面的差异.结果 老年人上消化道出血原因主要为消化道溃疡、胃癌以及急性胃黏膜病变,中青年上消化道出血原因主要为消化道溃疡、急性胃黏膜病变以及食管静脉曲张.老年组并存疾病率为25.4%,显著高于非老年组的3.20%(P < 0.05),且老年组主要的并发症为肺部感染.老年组出现呕血和排暗红色血便、单纯排黑便以及出现低血压或休克的比例明显高于非老年组(P < 0.05),且老年组多死于慢性疾病或并发症,明显高于非老年组(P < 0.05);而非老年组主要死于食管静脉曲张破裂.结论 老年人上消化道出血与中青年上消化道出血在出血病因、并存疾病、临床特征及病死原因等方面存在较大差别,在老年上消化道出血治疗中应予以注意.%Objective To investigate the differences in bleeding etiology, comorbidity, clinical characteristics and causes of upper gastrointestinal bleeding between the aged and the yong. Methods Datas of 138 old cases with upper gastrointestinal bleeding received from January 2009 to December 2011, and 312 young cases with upper gastrointestinal bleeding received at the same time period were retrospectively analyzed. The differences in bleeding etiology, comorbidity, clinical characteristics and causes of both old and young cases were investigated. Results The main causes of upper gastrointestinal bleeding of the elderly was pepticulcer, gastric cancer and acute gastric mucosal lesions while of the young was pepticulcer, acute gastric mucosal lesions and esophageal varices. The rate of coexisting diseases of the older was 25.4%, significantly higher than non-elderly group 3.30% (P < 0.05), and the major complications of the older group was lung infection. The rate of vomiting and dark red, black stool and showing hypotension or shock was significantly higher than non- elderly group (P < 0.05). The elder mainly died of chronic disease or complications, higher than non- elderly group (P < 0.05) while the non-elderly mainly died of esophagel varices. Conclusion There is a great difference between the elder and non-elderly in bleeding etiology, comorbidity, clinical characteristics and causes of upper gastrointestinal bleeding which should be noted when treating the upper gastrointestinal bleeding of the elder.
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