Analysis Of The Influence Factors Of Elderly Peptic Ulcer Complicated With Upper Gastrointestinal Bleeding

Objective: Through the retrospective analysis of nearly 6 years patients who saw a doctor in the second hospital of Jilin University due to elderly patients with peptic ulcer complicated with upper gastrointestinal bleeding,investigate the clinical characteristic of the disease and related risk factors and further understand the rule of the disease in this area.Then attract the attention of clinicians and patients,to set early development of corresponding prevention and control measures,better reduce complications and improve healing rate.Methods: Choose the patients who were treated in the second hospital of Jilin University during January 2010 to December 2015 due to peptic ulcer,each patient took digestive endoscopy and proved diagnosis of peptic ulcer.After the inclusion,exclusion criteria,the final total of 977 cases of patients were included in the study.Collection the patients,gender,age,the incidence seasons,symptoms,vital signs,living habits,special medication history and the history of HP infection.977 Patients were divided into three groups,respectively,elderly group with bleeding,elderly group without bleeding,young group with bleeding.Analyze the clinical features of patients in elderly group and the rule of disease.Elderly group with bleeding was compared with elderly group without bleeding,young group with bleeding respectively.Finally,analyze the risk factors which lead to bleeding by multi-factor logistic regression analysis.Results: 1.The incidence of elderly peptic ulcer complicated with upper gastrointestinal bleeding decreased year by year,male patients was significantly higher than that of female and the high number of the onset of autumn and winter than in spring and summer.2.The great majority of patients with clinical manifestations were dark stools.3.The low proportion of patients with abdominal pain regularly,with the proportion of non-specific symptoms or no symptoms is relatively high.4.There was a high proportion of patients with a history of drinking in elderly group with bleeding,the difference was statistically significant(P<0.05),and the rest factors in gender had no significant difference(P>0.05).5.In elderly group with bleeding,the proportion of men is higher,the difference was statistically significant(P<0.05).6.A high proportion of the elderly group with bleeding during the autumn and winter,the difference was statistically significant(P<0.05).7.The proportions of elderly group with bleeding which have enormous ulcer,combined ulcer,active ulcer,time is not less than six months were higher than that in elderly group without bleeding,the differences were statistically significant(P < 0.05).8.The proportions of elderly group with bleeding who have the habits of smoking or drinking were higher than that in elderly group without bleeding,the differences were statistically significant(P < 0.05).The proportions of elderly group with bleeding who used NSAIDs,anticoagulants,hormones,NSAIDs and anticoagulation,positive rate of HP were high,the differences were statistically significant(P < 0.05).9.Old-age hemorrhage group compared with non-elderly group,there was no significant difference in sex or seasons(P> 0.05).10.The regularity in the proportion of upper abdominal pain in elderly group were significantly lower than non-senile group,with significant difference(P<0.05);Old hemorrhage group,the proportion of patients with asymptomatic and non-specific symptoms was higher than non-elderly group,the difference was statistically significant(P<0.05).11.The proportions of huge ulcer,compound ulcer in old hemorrhage group were higher than non-elderly group,the difference was statistically significant(P<0.05);Between the two groups,whether in active stage ulcer,there were no significant differences(P >0.05).12.The proportion of HP,NSAIDs or(and)anticoagulants,hormones and other drugs in the elderly group was higher than that in the non-elderly group,the difference was statistically significant(P <0.05).There was no significant difference in the history of smoking and history of alcohol consumption between the two groups(P> 0.05).Conclusion: 1.The incidence of peptic ulcer complicated with gastrointestinal bleeding was declining year by year.The number of patients in autumn and winter was significantly higher than that in spring and summer,and the proportion of male patients was higher than that of females,and a higher proportion of male have drinking history.2.The risk factors which are closely related to the occurrence of bleeding in the elderly with PU are male,bad habits(smoking,drinking),special medication history(NSAIDs,anticoagulants,hormones),autumn and winter,huge ulcers,compound ulcers,duration ≥6 months,HP infection,so elderly patients should quit smoking,alcohol,taking special drugs should be alert to the emergence of complications,HP-positive treatment in a timely manner,and pay attention to regular physical examination.3.In elderly patients with peptic ulcer complicated with bleeding,a high proportion of patients have no clinical symptoms,therefore,in elderly patients without any clinical symptoms remains to be alert to the possibility of ulcer bleeding.