| ObjectiveAnalyzing the etiological characteristics of upper gastrointestinal hemorrhage cases in Digestive Department of Affiliated Hospital of Taishan Medical College during the last 6 years and to improve the understanding of the characteristics of upper gastrointestinal hemorrhage in the surrounding area of this hospital,so as to provide evidence for further standardizing the diagnosis and treatment of upper gastrointestinal hemorrhage.MethodsA total of 919 cases of upper gastrointestinal hemorrhage patients with complete clinical data and etiologies were determined,from January 2012 to December 2017,were collected from the Digestive Department of Affiliated Hospital of Taishan Medical University.According to gender,the patients were divided into male group and female group;according to the admission age,the patients were divided into youth group(younger than 35 years old),middle age group(36 years to 59 years old),and elderly group(over 60 years old);and the six year interval was divided into the first 3 years(from January 2012 to December 2014)and the last 3 years(from January 2015 to December 2017).A registration form was set up,the information of patients including name,age,sex,admission time,way of bleeding,blood pressure,heart rate,degree of anemia,combined disease,the cause of rebleeding and death were recorded and sorted one by one,and the characteristics of each information were summarized.To explore the etiological constitution of upper gastrointestinal hemorrhage,and the relationship of the top six causes with gender and age.The changes in the composition of the top six causes and the incidence of upper gastrointestinal hemorrhage in different sex and age groups were compared between the first 3 years and the last 3 years.All the data were analyzed using SPSS 22.0 statistical software.The count data were expressed in frequency and percentage.The comparison between groups used chi-square test,P < 0.05,the difference was statistically significant.Results1.The top six causes were: 209 cases of duodenal ulcer(22.74%),198 cases of acute gastric mucosal lesion(20.57%),178 cases of gastric ulcer(19.37%),esophageal and gastric varices in 103 cases(11.21%),71 cases of gastric cancer(7.73%),39 cases of compound ulcer(4.24%),duodenal ulcer accounts for 49.1% of peptic ulcers.2.Comparison and analysis of different groups show that the incidence of duodenal ulcer in young group was higher than that in the elderly group(P < 0.05);acute gastric mucosal lesion incidence of young group and old age group were higher than that in middle age group(P < 0.05);the incidence of gastric ulcer in elderly group was higher than that in young group(P < 0.05);esophageal and gastric varices bleeding incidence in middle-aged group was higher than that in young group(P < 0.05);the incidence of gastric cancer in elderly group than that in young group(P < 0.05);the incidence of compound ulcers in the elderly group was higher than that in the young group(P > 0.05),without significant statistical significance.3.The proportion of men and women with upper gastrointestinal hemorrhage was 3.2:1.The main causes of male were duodenal ulcer(28.03%),gastric ulcer(23.05%),acute gastric mucosal lesion(23.05%),esophageal and gastric varices(12.44%),gastric cancer(8.96%)and compound ulcer(4.48%).The main causes of female were acute gastric mucosal lesions(26.88%),duodenal ulcer(21.51%),gastric ulcer(20.97%),esophageal and gastric varices(15.05%),gastric cancer(9.14%)and compound ulcer(6.45%).4.The composition of duodenal ulcer in male patients was significantly higher than that of women(P < 0.05),and the difference was statistically significant.The composition of gastric ulcer in male patients was slightly higher than that of women(P < 0.05),but the difference was not statistically significant.The composition of acute gastric mucosal lesion,esophageal and gastric varices,gastric cancer(8.96%)and compound ulcer in female patients was slightly higher than that of men(P < 0.05),but the difference was not statistically significant.5.Compared to the previous 3 years(2012.01-2014.12)and the last 3 years(2015.01-2017.12)of upper digestive tract hemorrhage causes show that the ratio of peptic ulcer(duodenal ulcer,gastric ulcer,complex ulcer)decreased from 56.5% to 42%(P < 0.05);the ratio of duodenal ulcer decreased from 29.5% to 22%(P < 0.05);the ratio of acute gastric mucosal lesions increased from 19.7% to 27.7%(P < 0.05);the ratio of esophageal and gastric varices increased from 9.1% to 15.4%(P < 0.05);the proportion of gastric ulcer,gastric cancer and compound ulcer changed little(P > 0.05),and there was no statistical significance.6.The incidence of gastrointestinal bleeding in the first 3 years(2012.01-2014.12)and last 3 years(2015.01-2017.12)in different age group was compared.The proportion of young group patients decreased from 19.62 to 10.18(P < 0.05),the proportion of elderly patients increased from 38.52 to 20.90(P < 0.05),and the proportion of middle-aged group changed little(P > 0.05),and there was no statistical significance.7.The gender composition of the etiology of gastrointestinal bleeding in the first 3 years(2012.01-2014.12)and last 3 years(2015.01-2017.12)was compared.The proportion of male patients increased slightly,and the proportion of female patients decreased slightly,but the difference was not statistically significant(P > 0.05).Conclusion1.Upper gastrointestinal bleeding occurs mostly in middle and old patients.The main cause of upper gastrointestinal bleeding in middle and young people is duodenal ulcer.The main disease of upper gastrointestinal hemorrhage in the elderly is due to acute gastric mucosal lesion.2.The proportion of male patients with upper gastrointestinal bleeding is significantly higher than that of women.Among them,duodenal ulcer patients are mainly male.3.Compared with the previous three years,the proportion of young patients with upper gastrointestinal hemorrhage has decreased,and the proportion of elderly patients has increased in the last three years.The proportion of peptic ulcer,especially duodenal ulcer,has declined,while the proportion of acute gastric mucosal lesion and esophageal and gastric varices has increased.4.Compared with the previous three years,the proportion of male patients has slightly increased and the proportion of female patients has decreased slightly in the last three years,but the gender composition of upper gastrointestinal hemorrhage patients did not change significantly. |
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