| Research background and purpose:Upper Gastrointestinal Bleeding(UGIB)refers to hemorrhage caused by gastrointestinal lesions above the Kleb's ligament.If the diagnosis and treatment are not timely,it will seriously endanger the physical and mental health of the patients.It is a potentially life-threatening event in clinical practice.The complicated and complicated causes of UGIB,early diagnosis and early treatment are the keys to reducing mortality.With the improvement of people's living standards and the aging of the population in recent years,the clinical disease spectrum has also changed significantly.The purpose of this study is to deepen the understanding of the current UGIB among clinical doctors by collecting clinical data of UGIB patients in the Department of Gastroenterology of the AffiliatedHospital of Southwestern Medical University and consulting the relevantUGIB articles from January 2005 to December 2016 through the Chinese literature system.Clinical diagnosis and treatment,accurate diagnosis and timely treatment of UGIB patients.Method:The clinical data of 1740 patients admitted to the hospital from the Department of Gastroenterology of the Affiliated Hospital of Southwest Medical University from July 2013 to June 2017 due to UGIB admission were collected.A total of 1301 patients were included in the study after screening through strict inclusion criteria and exclusion criteria.The medical records of 1301 UGIB inpatients were retrospectively analyzed.A questionnaire was drawn up to register the basic data of each patient meeting the inclusion criteria in detail.Basic diseases,clinical features,gastroscopy,and laboratory examination results were collected and analyzed for statistical analysis.Through the relevant literature system in China,the articles on UGIB from January 2005 to December 2016 were searched.A total of 34,345 articles were obtained.Through strict literature inclusion criteria and exclusion criteria,a total of 139 clinical articles were included and 60,471 patients were included in this study.To investigate the clinical features,causes of etiologic changes in UGIB in China in the past 12 years,and the etiology and composition of UGIB in special populations.A database was created using Microsoft Excel 2007 and statistical analysis was performed using SPSS 24.0 statistical software.The specific data is represented by the number of cases and percentage(%),the measurement data is represented by X±s difference,the measurement data are compared using the t-test,the count data are compared by ?2,and P<0.05 is considered statistically significant.The descriptive analysis of the etiology of UGIB was performed.P<0.05 was considered statistically significant.Result:(?)Retrospective analysis of clinical features of upper gastrointes tinal bleeding in Southern Sichuan(1301 cases).1.cause of disease:(1)The top 5 causes of UGIB were peptic ulcer(PU),esophageal and gastric varices bleeding(EGVB),and Portal Hypertensive Gastropathy(PHG).Acute Gastric Mucosal Lesions(AGML),Malignant Tumors;(2)Comparison of etiology between the previous and the last two years,PU was still the main cause,but the incidence rate decreased from 47.1% to 34.0%(P<0.05),followed by EGVB,its incidence increased from 25.7%.It rose to 31.4%(P<0.05),and the incidence of AGML increased from 5.8% to 8.7%(P<0.05),from the fourth cause to the third cause;(3)The EVGB was the most common cause of hemorrhage in young and middle-age group(P<0.05),and gastric ulcer was the most common in elderly patients(P<0.05).(4)Gastric ulcer(GU)and malignant tumors occurred in the elderly group(P<0.05).Duodenal Ucler(DU)and AGML occurred in the young group(P<0.05).EGVB and PHG were all found in the young and middle-age group(P<0.05).2.Age:The male and female ratio is 2.44:1,the average male age(55.8 +14),significantly less than the average age of women(61.5+13.6)years of age(P < 0.05);constituent ratio before and after two years of age,the young and middle-aged group decreased the proportion of elderly group but increased the proportion of P>0.05;compared with 2 years ago the average age,the decline in the young group(P<0.05),theaverage age of the elderly group increased(P<0.05);3.The amount of bleeding:The amount of bleeding in the elderly group was greater than that in the young and middle-age group(P<0.05),and the degree of anemia was greater than that in the young and middle-age group(P <0.05),and the shock index was greater than that in the young and middle-age group(P<0.05).4.The inducement:The incidence of drug related UGIB in the elderly group was the highest(P<0.05),and the incidence of UGIB youth group caused by drinking was the highest(P<0.05).5.Seasonality:There was no statistical difference between the four seasons in the distribution of UGIB(P>0.05).The incidence of EGVB in winter was the highest(P<0.05),and the other etiological factors were statistically different among the four seasons(P>0.05).6.Clinical outcome:The mortality rate of the elderly group was greater than that in the young and middle-age group(P<0.05),and the cause of death was mainly EGVB.(?)Analysis of epidemiological characteristics of upper gastroint estinal bleeding in China:1.The main cause of 1,China UGIB followed by PU,EGVB,AGML,malignant tumor accounted for 54%,14.9%,12.5%,9.5%;2011 to 2016 compared with the 2005 to 2010,PU,AGML,the proportion of malignant tumors of unknown etiology,the proportion decreased,increased EGVB,Mallory-Weiss syndrome(P<0.05);the proportion of male UGIB decreased,the proportion of women increased(P<0.05).2.The main causes of UGIB in the elderly were PU,malignant tumor,AGML and EGVB.Compared with the adult group,the proportion of men decreased,the proportion of women increased(P<0.05),and the mortality rate was significantly greater than that in the adultgroup(P<0.05).3.the main causes of childhood UGIB were PU,AGML,rare etiology and unknown etiology.Compared with the adult group,the proportion of male decreased,and the proportion of women increased(P<0.05).2.the north and south of the main cause was followed by PU,EGVB,AGML,malignant tumor,of which South PU,the incidence rate of AGML was significantly higher than that of the North(P<0.05),EGVB,the incidence of malignant tumor,the incidence rate of Mallory-Weiss syndrome was significantly lower than that in the North(P<0.05),the South and north side and gender differences the mortality rate was not statistically significant(P>0.05).In Conclusion:(?)Retrospective analysis of clinical features of upper gastrointes tinal bleeding in Southern Sichuan(1301 cases):The analysis of UGIB1301 patients from July 2013 to June 2017 in our hospital showed that the age of onset of UGIB has an increasing trend.The causes are PU,EGVB,PHG,AGML,and malignant tumors.The causes of the two groups are different.The percentage of the proportion has changed.UGIB is dominated by males,but the incidence of females is higher than that of two years ago.There are significant differences in the main causes,incentives,blood loss,and death of UGIB in different age groups.EGVB occurs in winter.For the treatment of clinical features of different age groups,targeted measures should be taken.(?)Analysis of epidemiological characteristics of upper gastroint estinal bleeding in China:PU,EGVB,AGML and malignant tumors are the major causes of UGIB in China.The etiology and gender of UGIB have changed significantly in the past 6 years.The composition of the etiology,sex ratio,and mortality rate of people of different ages have obvious changes,and the etiology of the different regions also has obvious changes. |
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