The elderly's upper digestive tract bleeding characteristic _ symptom

The elderly's upper digestive tract bleeding characteristic _ symptom
The elderly's upper digestive tract bleeding characteristic

World Chinese digests the magazine Vol. 0 of number 8 of 1998 Clinical experience

Author: The road is big

Unit: Internal medicine department of first hospital of Tianjin 300010

Keyword: Stomach enterorrhagia diagnosis; Stomach enterorrhagia treatment; Gastroscope skill; Mucous membrane of stomach pathology

Subject headingsgastrointestinal hemorrhage/diagnosis; gastrointestinal hemorrhage/therapy; gastroscopy; gastric mucosa/pathology

Chinese books and reference materials classification numberR 573.204 R 573.205

A target and method

1.1Target100 old age upper digestive tract bleeding patients that this text reported 1995-03/ 1998-02 accepted for medical treatment. 76 men among them, 24 women, the man: The woman is 3.17: 1. - 83 years old, 70 average years olds 60 years old; The number of the person who has digestive system symptom and medical history is 64 before the onset, the above-mentioned digestive tract bled for 36 persons who firsts publish symptom; Suffer from 84 important internal organs such as the heart, lung, brain, kidney,etc. at the same time; Check by the inner mirror (76) And the upper digestive tract radiography is checked (24) Definite diagnosis is: Gastric ulcer (GU) ,Mucomembranous pathological change (AMGL) of the acute stomach , duodenum ball ulcer (DU) , the gastric carcinoma (including incomplete gastric carcinoma) , cancer of the esophagus, oesophageal the intersection of fundus of stomach and the intersection of song and pieces of vein it breaks the persons who bleed to be respectively 28, 26, 21, 18, 4And 3, persons who bleed (500 mL in a small amount) 24, medium-sized quantity bleeds (500 mL- 1000 mL) 47 cases,it is generous bleed Person 29 case.

1.2Method Adopt Support to treat: Offer styptically, fluid infusion, blood transfusion, resisting shock, maintain electrolytic acid-base balance of water. The treatment of cause of disease: Such as to peptic ulcer (PU) And AMGL person adds and uses H2The receptor resists pharmaceuticals or proton pump inhibitors short of moneyly, protect the mucous membrane of stomach, resist Hp medicine, break the persons who bleed to a vein of song of oesophageal fundus of stomach, add and use pituitrin,etc.. To the important internal organs damaged, direct against different diseases, give the corresponding treatment.

2 results

Through treating 78 (AMGL among them, GU, DU, tumour, cirrhosis are respectively 24, 20, 16, 16And 2) Bleeding stops, but 29 among them bleed in 3 d again after eating, the bleeding rate is 37.17%, after continuing treating, bleeding stops leaving hospital. 3 DUs, medicine of 5 GU persons who bleed fails to respond to any medical treatment, is cured and leaves hospital by the surgery. 3 gastric carcinomas later period, 2 DUs, 3 GUs, 2 AMGLs, 2 incomplete gastric carcinomas, a case of cancer of the esophagus, a oesophageal fundus of stomach and a vein of song breaks the person who bleeds (amount to 14) Amalgamate other important the intersection of internal organs and illness at the same time, it bleeds to be function depleted to bring out many internal organs death, 14% of mortality.

3 is discussed

It is the elderly's common acute disease that the upper digestive tract bleeds. Its cause of disease is reported at home: It is mainly PU (41.7%) in the elderly And gastric carcinoma (32.6%) ,Young people are mainly PU (45%) And gastritis (32%) . This text materials reveal, in the cause of disease bleeding in the elderly's upper digestive tract still with PU (49%, especially GU28%) And AMGL (26%) The majority, secondly it is tumour (22%) . This brief we on, at treating and curing the elderly when digestive tract bleed, should consider common disease at first, highly watch out for tumour at the same time. There are 36% of the patients that had no digestive system symptom in 100 of this text before bleeding, but regarded bleeding as and firsted publish symptom, relatively young people meet more on this point. In addition, the persons who bleed in short term after treating and bleeding and stopping are up to 37.17%, prove the elderly are low because of the supersession function, the regenerated ability of cell is bad, although bleeding stop temporarily, cause pathological change bleeding not to resume completely in short term, so, after bleeding and stopping, should lengthen and strengthen its treatment of cause of disease appropriately, it should be late too to have meal. In addition, bad because of the elderly's blood vessel elasticity, styptic mechanism weakens oneself, so the bleeding amount is relatively big, China's severe bleeding person reaches 76%, in addition amalgamate more other important internal organs diseases (84%) Massive haemorrhage can aggravate the original internal organs to damage, causing many internal organs functions to be depleted and death.

Communication authorThe road is big

Accept draft date 1998-03-18 Repair until date 1998-04-29
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