| Objective: To analyze the epidemiological characteristics, etiology, clinical characteristics and treatment of upper gastrointestinal bleeding in order to improve the level of diagnosis and treatment of the disease.Methods: According to this purposes, Retrospectively collecting and analyzing the clinical date of the patients with UGIB which came from the digestive department of Hubei Provincial Traditional Chinese Medical Hospital in guanggu from 1 January 2015 to 31 December 2015. To summarize its epidemiological characteristics(Age, sex, time of onset, incentives).To summarize its causes,symptom and treatment and diagnosis characteristics. Comparing its hospital stay, hospital costs.Results: 1. General data:There were 122 cases of UGIB in our hospital during the past year, 105 males and 17 females, and the ratio of male to female was 1:0.16. The average age of onset was 49.69 ± 19.19 years old. The men's average age of onset was 44.37± 19.03 years old. The women's average age of onset was 51.59± 19.66 years old. There was no significant difference in age of onset between male and female. Both male and female patients were mainly young patients. Winter is the main season of UGIB. Repeated hospitalization due to the disease accounted for 24.59%. 2. Clinical data: There are 4 types of UGIB's initial symptoms,respectively, melena 75 cases(61.48%), haematemesis and melena 32 cases(26.23%), haematemesis 12 cases(9.83%), abdominal pain 3 cases(2.46%).The average time was 3.91±4.01 days for the patients with initial symptoms of melena before admission. 1.17±0.39 days for the patients with haematemesis. 2.19±1.93 days for the patients with haematemesis and melena. 3.00±1.00 days for the patients with abdominal pain. There were significant differences in the treatment time between melena and haematemesis(P <0.05). There were no significant differences in the treatment time between melena and abdominal pain(P >0.05). The average day of patients with previous history of digestive tract was 2.59 ± 2.15 days. The average day of patients with no previous history was 4.19 ± 4.72 days. The patients with previous history of digestive tract got medical treatment timely than patients with no previous history. In incentive aspect, uncontrolled diet and alcohol 24 cases(19.67%),drug factors 9 cases(7.38%),overwork 3 cases(2.46%),for no reason 86 cases(70.49%).The first five causes of UGIB were duodenal ulcer(68 cases,55.73%),compound ulcer(14 cases,11.47%),gastric ulcer(12 cases,9.84%),EGVB(6 cases,4.92%) and acute gastric mucosal lesion(4 cases,3.28%).Peptic ulcer is the main cause of UGIB. 3.Biochemical indicators : The positive rate of OB was 100%. HGB, RBC, HCT, BUN need dynamic observation. In the blood type aspect, most patients' blood type was O-type blood(46 cases),than A-type blood(30 cases), B-type blood(28 cases), AB-type blood(9 cases). 4.Severity evaluation: There were 70 cases mild patients(57.38%),32 cases moderate patients(26.23%), 20 cases severe patients(16.39%).Most of the patients were mild and moderate. 5. Treatment and curative effect: 6 cases of EGVB patients, 4 cases were treated by endoscopic therapy, 1 cases were treated by conservative therapy, 5patients were discharged from hospital. One patients was transferred from one hospital to another on the first day. The rate of endoscopic treatment of 110 cases of NVUGIB patients was 10.91%, and the coverage rate of acid suppressive drugs was 100%, and the utilization rate of traditional Chinese medicine was 34.55%.Without any traditional Chinese medicine treatment for patients were Western medicine treatment group, patients who got traditional Chinese medicine treatment and conventional treatment of Western medicine were combination therapy group. Combination therapy group's total effective rate was 97.37% which was higher than the total effective rate of 83.34% in the western medicine group(P<0.05).The hospital costs of combination therapy group was less than Western medicine treatment group's. There was no statistical difference between the two groups in the length of hospital stay(P>0.05).Conclusion: The incidence rate of male was higher than that of female of UGIB. The incidence of the population in the region are mostly young people. UGIB happened in all seasons,but it had a high incidence in winter. Emergency endoscopy is the main method for the diagnosis of UGIB. Peptic ulcer was the first cause of disease, followed by EGVB, acute erosive gastritis. Predisposing factors were uncontrolled diet, drug factors and overwork. Sufficient PPI was the key point for the treatment of UGIB. The Combination treatment of traditional Chinese and Western medicine of UGIB has obvious curative effect. It could shorten the time of stool turning yellow, reduce the cost of hospitalization. The Combination treatment Worth promoting. The prevention of UGIB is also important. |
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