目的 观察不同年龄段患者上消化道出血的临床特征,并对导致不同年龄段患者发生上消化道出血的危险因素进行比较,旨在为临床早期干预治疗提供切入点。方法 回顾性分析,采集我院2018年1月至2019年12月收治的180例上消化道出血患者临床资料,根据入组患者的年龄分布情况进行分组,将其中年龄≥60岁上消化道出血114例患者纳入老年出血组,将其中年龄＜45岁上消化道出血66例患者纳入青年出血组组,对比不同年龄段上消化道出血患者的临床特征,并对导致患者上消化道出血的危险因素进行比较分析。结果 青年出血组组患者以上腹部疼痛、贫血、黑便为主要临床特征,老年出血组则主要表现为贫血、黑便、失血性休克。两组临床特征相比,青年出血组组患者上腹部疼痛占比高于老年组,贫血及肝硬化门脉高压占比低于老年组,差异有统计学意义(P＜0.05)；不同年龄段患者上消化道出血危险因素比较,青年出血组组患者主要以消化溃疡、糜烂性胃炎与贲门撕裂为主,老年出血组患者以消化溃疡、糜烂性胃炎、肝硬化、消化道肿瘤糜烂性胃炎为主,两组患者上消化道出血危险因素比较,与青年出血组患者相比,老年出血组患者糜烂性胃炎占比较低,消化道肿瘤糜烂性胃炎占比较高,差异有统计学意义(P＜0.05)；两组消化溃疡、贲门撕裂、肝硬化危险因素比较,差异无统计学意义(P＞0.05)。结论 贫血与黑便是上消化道出血患者共有的临床特征,上腹部疼痛是中青年患者特有表现,失血性休克则多见于老年患者；危险因素方面,消化溃疡、糜烂性胃炎均在两个年龄段有体现,贲门撕裂是中青年患者独立危险因素,其他因肝硬化、消化道肿瘤糜烂性胃炎引起的出血则在老年患者中常见,临床可根据不同的出血特征及不同年龄段患者特有的危险因素进行早期风险控制,以减少出血的发生。

Objective To observe the clinical features of upper gastrointestinal bleeding in patients with different ages, to compare the risk factors of upper gastrointestinal bleeding in different age groups, and to provide an entry point for early clinical intervention. Methods Retrospectively analyzed, the clinical data of 180 patients with upper gastrointestinal bleeding treated in our hospital from January 2018 to December 2019 was collected, and grouped them according to the age distribution of the enrolled patients. Among them, 114 patients with upper gastrointestinal bleeding aged ≥60 years old were included in the elderly bleeding group, and 66 patients with upper gastrointestinal bleeding aged <45 years old were included in the young bleeding group. The clinical features of upper gastrointestinal bleeding patients with different ages were compared, and the risk factors of upper gastrointestinal bleeding were analyzed. Results The main clinical features of patients in young bleeding group were upper abdominal pain, anemia and melena, and the main features of patients in elderly bleeding group were anemia, melena and hemorrhagic shock. The proportion of upper abdominal pain in young bleeding group was higher than that in elderly bleeding group, and the proportion of anemia and cirrhotic portal hypertension in young bleeding group was lower than that in elderly bleeding group, and the difference was statistically significant (P<0.05); The risk factors of upper gastrointestinal bleeding in patients of different ages were compared, the patients in young bleeding group were mainly peptic ulcer, erosive gastritis and cardia tear, while the patients in elderly bleeding group were mainly peptic ulcer, erosive gastritis, liver cirrhosis, gastrointestinal cancer and erosive gastritis, and the proportion of erosive gastritis in elderly bleeding group was lower than that in young bleeding group, and the proportion of gastrointestinal cancer and erosive gastritis in elderly bleeding group was higher than that in young bleeding group (P<0.05); There was no statistical difference in the risk factors such as peptic ulcer, cardia tear, erosive gastritis, liver cirrhosis between the two groups (P>0.05). Conclusion Anemia and melena are common clinical features of patients with upper gastrointestinal bleeding, upper abdominal pain is a characteristic manifestation of young and middle-aged patients, while hemorrhagic shock is more common in elderly patients; In terms of risk factors, peptic ulcer and erosive gastritis are manifested in two age groups. Cardia tear is an independent risk factor for young and middle-aged patients, and the other bleeding caused by liver cirrhosis and gastrointestinal cancer and erosive gastritis is common in elderly patients. Clinically, early risk control can be performed according to different bleeding characteristics and risk factors unique to patients with different ages to reduce the occurrence of bleeding.