【摘要】 目的探讨老年人服用非甾体类抗炎药(NSAIDs)致上消化道出血的临床及内镜特征。方法回顾性分析2003～2007年5年因上消化道出血住院患者的临床资料,依据1周内是否服用过NSAIDs,分为NSAIDs组和非NSAIDs组,对临床资料及内镜检查结果进行对比分析。结果 753例非食管胃静脉曲张上消化道出血住院患者中有76例(10.1%)发病前1周内有服用过NSAIDs药物史。比较两组患者性别、幽门螺杆菌感染情况,出血程度等差异无统计学意义(P>0.05),但NSAIDs组年龄明显偏大,伴有心脑血管病和骨关节病,出血前常无消化道症状,与非NSAIDs组相比差异有统计学意义(P<0.01)。NSAIDs组内镜检查以胃溃疡和糜烂出血为主要病变,与非NSAIDs组相比有非常显著性差异(P<0.01)。结论老年人应尽量减少NSAIDs的使用,必须服用者应注意观察上消化道症状,必要时加服胃黏膜保护剂干预以减少或预防胃肠道不良反应。更多还原

【Abstract】 Objective To investigate the clinical presentation and endoscopy characteristics of upper gastrointestinal tract bleeding induced by nonsteroidal anti-inflammatory drugs (NSAIDs) in eldly patients. Methods Eldly patients who were proven upper gastrointestinal tract bleeding from Jan, 2003 to Jan, 2007 were analyzed retrospectively. They were divided into two groups(NSAIDs group and non-NSAIDs group) according to whether NSAIDs were taken in the last week. Results Of 753 patients in hospital with upper gastrointestinal tract bleeding, 76 patients had taken NSAIDs before onset of the disease. The age and the rate of cardio-cerebrovascular disease and osteoarthropathy, presymptom before digestive tract bleeding, gastric ulcer and erosive hemorrhagic gastritis in NSAIDs group were significantly higher than that in non-NSAIDs group (P<0. 01). However, there were no markedly difference of sex, helicobacter pylori infective rate, heamorrhage degree, and past history of peptic ulcer between the two groups (P>0.05). Comparing with non-NSAIDs group, NSAIDs group had more endoscopic bleeding gastric ulcer and erosion (P<0.01) .Conclusion NSAIDs consumption should be reduced as less as possible in elderly patients. The upper digestive tract complicated should be alert and proper measures should be employed to reduce the side effect of NSAIDs if these drugs have to be administrated.更多还原