Abstract：Objective To evaluate the cause of bleeding in emergency consultations with upper gastrointestinal bleeding. Methods A retrospective study of cases of upper gastrointestinal bleeding in the emergency consultation of Department of Gastrointestinal, the First Medical Center, Chinese People′s Liberation of China General Hospital from June 2018 to June 2019, relevant clinical data of patients were collected, and the etiological composition of patients of different genders and ages were analyzed. Results A total of 1187 cases of upper gastrointestinal bleeding in emergency consultation were included in this study, including 752 cases in the male group and 435 cases in the female group; 628 cases in the young and middle-aged group (＜60 years old), and 559 cases in the elderly group (≥60 years old). The common causes were 480 cases of decompensated portal hypertension in liver cirrhosis, 310 cases of non-steroidal anti-inflammatory drug (NSAID) related acute gastric mucosal disease, 177 cases of peptic ulcer, 117 cases of malignant tumor, and 34 cases of vascular malformations, 19 cases of cardiac mucosal tear syndrome, 16 cases of gastric stromal tumor, and 34 cases of unknown cause. The proportion of peptic ulcers in the male group was higher than that in the female group, and the difference was statistically significant (P ＜ 0.05). The proportions of portal hypertension, peptic ulcer, and cardiac mucosal tear syndrome during decompensated liver cirrhosis in the young and middle-aged group were higher than those of the elderly group, while the proportions of NSAID-related acute gastric mucosal lesions and malignant tumors were lower than those of the elderly group, and the differences were highly statistically significant (P ＜ 0.01). Conclusion Age and gender factors can affect the cause of acute upper gastrointestinal bleeding.
沈蕾 孙刚 张晓梅. 1187例上消化道出血急会诊的病因分析[J]. 中国医药导报, 2020, 17(31): 111-114.
SHEN Lei SUN Gang ZHANG Xiaomei. Analysis of the cause of emergency consultation in 1187 cases of upper gastrointestinal bleeding. 中国医药导报, 2020, 17(31): 111-114.
[1] Garcia-Tsao G. Current management of the complications of cirrhosis and portal hypertension：variceal hemorrhage，ascites，and spontaneous bacterial peritonitis [J]. Dig Dis，2016，34（4）：382-386.
[2] 吕志强，谭涛，赖斌，等.急诊床旁胃镜诊治急性上消化道大出血60例[J].武警医学，2019，30（2）：152-154.
[3] Garbuzenko DV. Current approaches to the management of patients with liver cirrhosis who have acute esophageal varicealbleeding [J]. Curr Med Res Opin，2016，32（3）：467-475.
[4] 周朝阳，李国庆.内窥镜用于急性非静脉曲张性上消化道出血的研究进展[J].临床合理用药，2020，13（4）：180-181.
[5] 陈平，袁晓琴，许兰涛，等.上海市嘉定地区2870例消化道溃疡内镜下改变临床分析[J].胃肠病学和肝病学杂志，2017，26（12）：1377-1381.
[6] 张文涛，姬涛，陈威，等.早期乳酸清除率预测急性上消化道出血重症患者预后的临床价值[J].解放军医学院学报，2017，38（10）：939-942.
[7] 孙永珍，谭学明.Blatchford、Rockall评分系统预测急性上消化道出血患者的预后[J].中国临床医生杂志，2020， 48（3）：302-305.
[8] 黄飚.老年人急性上消化道出血145例临床分析[J].广东医学院学报，2008，26（5）：534-536.
[9] Laine L，Yang H，Chang SC，et al. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009 [J]. Am J Gastroenterol，2012，107：1190-1196.
[10] Wuerth BA，Rockey DC. Changing epidemiology of upper gastrointestinal hemorrhage in the last decade：a nationwide analysis [J]. Dig Dis Sci，2018，63：1286-1293.
[11] 孙艳虹，钟威，朱秋婕.肝硬化与慢性乙型肝炎患者凝血指标及血小板参数的相关分析[J].标记免疫分析与临床，2018，25（11）：1603-1606.
[12] 张丽航，王善娟，陆伦根，等.凝血试验指标对肝硬化合并急性上消化道出血的预测价值[J].临床肝胆病杂志，2018，34（10）：2130-2135.
[13] 刘君茹.肝硬化患者凝血四项指标检验的临床意义[J].中国医药指南，2019，17（16）：144-145.
[14] Wong Grace LH，Lau Louis HS，Ching Jessica YL，et al. Prevention of recurrent idiopathic gastroduodenal ulcer bleeding：a double-blind，randomised trial [J]. Gut，2020， 69（4）：652-657.
[15] 史华兰.吸烟与消化性溃疡科普[J].全科口腔医学电子杂志，2019，6（30）：6.
[16] 杨南胜.内镜止血用于急性非静脉曲张性上消化道出血临床治疗的效果分析[J].中国医药指南，2019，17（22）：123-124.
[17] 文政伟，李秋兰，何均辉.消化内镜治疗非静脉曲张性上消化道出血的临床疗效分析[J].现代医院，2018，18（9）：1340-1342.
[18] 吕贤茂，陈波，许瑞华.急诊胃镜检查和治疗在急性上消化道出血疾病中的作用探讨[J].中国医药科学，2020， 10（13）：203-205.
[19] 安康，陈倩倩，李惠惠，等.75岁以上非静脉曲张性上消化道出血患者临床特点分析[J].解放军医学院学报，2016，37（7）：742-744，749.
[20] 万宁，张田甜，董艳敏.消化性溃疡史患者中小剂量阿司匹林相关的胃肠损伤预防性治疗的系统评价与Meta分析[J].中国医药导报，2019，16（3）：110-114，135.
[21] 郑由周，王翠云，沈洁.消化内镜治疗非静脉曲张性上消化道出血的临床研究[J].中国现代医生，2020，58（15）：49-51，55.
[22] 莫洁庭，田峰.非甾体类抗炎药致老年人上消化道出血的临床特点分析[J].中国实用医药，2016，11（18）：155-156.
[23] 陈敏艳，余恕玉.老年人上消化道出血113例临床分析[J].实用临床医学，2009，10（3）：32-33.
[24] Bibbins-Domingo K. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer：U.S. Preventive services task force recommendation statement [J]. Ann Intern Med，2016，164（12）：836-845.
[25] Chan FKL，Goh KL，Reddy N，et al. Management of patients on antithrombotic agents undergoing emergency and elective endoscopy：joint Asian Pacific Association of Gastroenterology （APAGE） and Asian Pacific Society for Digestive Endoscopy （APSDE） practice guidelines [J]. Gut，2018，67（3）：405-417.
[26] Sung JJ，Tsoi KK，Ma TK，et al. Causes of mortality in patients with peptic ulcer bleeding：a prospective cohort study of 10,428 cases [J]. Am J Gastroenterol，2010，105（1）：84-89.
[27] Shrestha B，Kc S，Chaudhary S，et al. Outcome of endoscopic variceal band ligation [J]. JNMA，2017，56（206）：198-202.
[28] Cho SH，Lee YS，Kim YJ，et al. Outcomes and role of urgent endoscopy in high-risk patients with acute nonvariceal gastrointestinal bleeding [J]. Clin Gastroenterol Hepatol，2018，16（3）：370-377.
[29] Lin HJ，Wang K，Perng CL，et al. Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study [J]. J Clin Gastroenterol，1996， 22：267-271.
2020, Vol. 17 
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