张艳梅 刘 卉 沈小春 兰春慧 陈东风 崔红利

第三军医大学大坪医院野战外科研究所消化内科(400042)

食管非静脉曲张破裂出血175例回顾性分析

张艳梅 刘 卉 沈小春 兰春慧 陈东风 崔红利*

第三军医大学大坪医院野战外科研究所消化内科(400042)

背景：食管非静脉曲张破裂出血临床并不常见，但严重者可危及生命。因此，对其进行回顾性分析可为临床诊断和治疗提供重要依据。目的：探讨食管非静脉曲张破裂出血的临床特征。方法：收集2006年1月—2016年12月第三军医大学大坪医院收治的175例食管非静脉曲张破裂出血患者，回顾性分析患者的性别、年龄、出血病因、好发部位、发病季节、治疗方式、预后等。结果：175例食管非静脉曲张破裂出血患者中，男女发病之比为 3.5∶1，73.1%的患者为中老年患者。食管非静脉曲张破裂出血的主要病因为贲门撕裂综合征(46.9%)、食管癌(23.4%)、食管溃疡(12.6%)和食管异物(12.0%)，食管下段是最常见的出血部位(70.9%)。51例患者接受内镜下治疗或外科手术治疗，142例(81.1%)患者经治疗后好转或治愈，27例(15.4%)患者死亡。结论：食管非静脉曲张破裂出血的男性发病率高于女性，多见于中老年患者。出血病因以贲门撕裂综合征多见，最常见的出血部位为食管下段。药物联合内镜下治疗是大部分食管非静脉曲张破裂出血的有效治疗方式。

食管非静脉曲张破裂出血； 治疗； 回顾性研究

Correspondenceto: CUI Hongli, Email: 2465517206@qq.com

Background: Esophageal non-variceal hemorrhage is relatively uncommon in clinical, however, it can be life-threatening in severe cases. Thus, retrospective analysis of esophageal non-variceal hemorrhage could provide important evidence for its diagnosis and treatment.Aims: To analyze the clinical characteristics of esophageal non-variceal hemorrhage.Methods: A total of 175 cases of esophageal non-variceal hemorrhage from January 2006 to December 2016 at Daping Hospital were enrolled. Gender, age, cause of bleeding, location of bleeding, season of onset, treatment and prognosis were retrospectively analyzed.Results: The ratio of male to female was 3.5∶1 in 175 patients with esophageal non-variceal hemorrhage, 73.1% of patients were middle-aged and elderly. The main cause of bleeding of esophageal non-variceal hemorrhage were cardiac mucosal laceration syndrome (46.9%), esophageal cancer (23.4%), esophageal ulcer (12.6%) and esophageal foreign body (12.0%). The most common site of bleeding was lower esophagus (70.9%). Fifty-one patients accepted endoscopic treatment or surgery. After treatment, 142 patients (81.1%) were cured or improved, and death was occurred in 27 patients (15.4%).Conclusions: The incidence of esophageal non-variceal hemorrhage is higher in male than in female, and is commonly seen in middle-aged and elderly patients. The most common cause of bleeding of esophageal non-variceal hemorrhage is cardiac mucosal laceration syndrome, and the most common site of bleeding is lower esophagus. Medicine combined with endoscopic treatment is effective for most of the patients.

KeywordsEsophageal Non-Variceal Hemorrhage; Therapy; Retrospective Studies

上消化道出血是临床常见的急危重症之一，主要病因有消化性溃疡、食管胃底静脉曲张破裂出血、急性胃黏膜病变、胃癌等[1-2]，病变部位和出血原因对治疗方案的选择和预后有重要影响。……