Clinical Characteristics And Risk Factors Of 255 Cases Of Lower Gastrointestinal Bleeding

Objective: The pathogenesis of lower gastrointestinal bleeding(LGIB)is complex,and its influencing factors and causes are various.this paper analyzed the clinical characteristics of 255 cases of LGIB in the Second Hospital of Tianjin Medical University in recent 5 years and the related risk factors of LGIB,in order to increase the understanding of LGIB,in order to take the correct and effective method to predict the condition and prognosis as soon as possible,and can effectively guide the clinical intervention,so as to reduce the morbidity and mortality as much as possible,and better improve the prognosis.Methods: The clinical data of 255 patients with LGIB admitted to the Gastroenterology Department of the Second Hospital of Tianjin Medical University from January 2012 to April 2017 were retrospectively analyzed.the clinical characteristics of 255 patients with non-LGIB were analyzed,and the risk factors of LGIB were screened out.In this study,SPSS 22.0 statistical software was used for statistical analysis.the mean standard deviation was used for the measurement data in accordance with the normal distribution.two independent samples t test was used for the comparison between the two groups.the variance analysis was used for the comparison between multiple groups,2 test was used for the counting data,and logistic regression analysis was used for the multivariate analysis.P<0.05 was statistically significant.Result: 1.255 cases of LGIB in the case group,136 cases of men(53.3%),119 cases of women(46.7%);The mean age of onset was(59.5±16.9)years.LGIB occurred in autumn(32.6%).153 cases(60.0%)were in the young group(<65y),102 cases(40.0%)in the old group(?65y);There was no significant difference in gender and hospitalization days between the two groups.2.In the case group,the top 5 causes were ulcerative colitis in 63 cases(24.7%),colorectal cancer in 58 cases(22.7%),hemorrhoids in 20 cases(7.8%),polyps in 19 cases(7.5%),ischemic colitis in 12 cases(4.7%).The top 5 etiological factors of young and middle-aged group(< 65y)were ulcerative colitis,colorectal cancer,polyps,hemorrhoids,ischemic colitis,and the top 5 etiological factors of elderly group(?65y)were colorectal cancer,hemorrhoids,ulcerative colitis,ischemic colitis,polyps.3.In the case group,blood stool was the first symptom in 159 cases,accompanied by abdominal pain in 127 cases.the other symptoms included diarrhea,asthenia,palpitation,dizziness,constipation,nausea and vomiting,weight after urgent,loss of appetite,abdominal distention,fever,abdominal discomfort,acid and heartburn.There were 119 cases without positive signs and 136 cases with positive signs,including 98 cases of abdominal tenderness,51 cases of anemia and 5 cases of abdominal mass.4.In the case group,19 patients(12.4%)in the middle-aged and young group and 32 patients(31.4%)in the old group needed blood transfusion.5.According to the analysis of the clinical test indexes in the case group,the decrease of RBC,Hb,PLT,A/G and ALB in the elderly group was higher than that in the young and middle-aged group(P<0.05).the increase of neutrophil percentage,APTT,PT,TBIL,DBIL,GGT,Cr and BUN in the elderly group was higher than that in the young and middle-aged group(P<0.05).6.In the case group,18 cases were cured,204 cases were improved,31 cases were invalid,2 cases died,the total effective rate of treatment was 87.1%,the mortality rate was 0.8%,the effective rate of treatment was middle-aged and young group>old group(P<0.05).7.Multivariate logistic regression analysis showed that cardiovascular history,arteriosclerosis,history of liver disease,history of kidney disease,number of drugs taken,infection,aspirin taking history were independent risk factors for LGIB;Arteriosclerosis,number of drugs taken and infection were independent risk factors for LGIB in young and middle-aged group(<65y).Aspirin administration history,arteriosclerosis,nephrotic history,and number of drugs taken were independent risk factors for LGIB in the elderly group(?65y).Conclusion:The high incidence of LGIB was mainly in the elderly people,which occurred in autumn.The main disease because of ulcerative colitis,colorectal cancer,hemorrhoids,etc.;The prognosis of the elderly is worse than that of the young and middle-aged.Multiple factors were associated with LGIB,among which cardiovascular history,arteriosclerosis,liver disease history,kidney disease history,drug intake,infection,aspirin administration history were independent risk factors for LGIB.It is very important to pay attention to the risk factors of LGIB and to distinguish the clinical features for the prevention and treatment of LGIB.