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在中国,消化性溃疡是导致非静脉曲张性上消化道出血(NVUGIB)的最常见原因。

Peptic Ulcer Is the Most Common Cause of Non-Variceal Upper-Gastrointestinal Bleeding (NVUGIB) in China.

机构信息

Department of Gastroenterology, The 2nd Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China (mainland).

Institute of Digestive Diseases, Chinese PLA General Hospital, Beijing, China (mainland).

出版信息

Med Sci Monit. 2018 Oct 6;24:7119-7129. doi: 10.12659/MSM.909560.

Abstract

BACKGROUND This study aimed to discover the common cause of non-variceal upper-gastrointestinal bleeding (NVUGIB) by conducting a multi-center retrospective study from 2008 to 2012. MATERIAL AND METHODS Hospitalized patients ages ≥18 years old, from 8 hospitals in China, diagnosed with NVUGIB by endoscopy from 1 January 2008 to 31 December 2012 were enrolled. Questionnaires were developed and a data-entry graphical user interface was designed by using EpiData software. RESULTS Total of 2977 hospitalized patients from 8 medical centers were included. A total of 95.47% (2842/2977) of patients were admitted to a general ward, 3.53% (105/2977) were admitted to an emergency ward, and 1.00% (31/2977) were admitted to an intensive care unit. Peptic ulcer remained the most common cause of NVUGIB (73.26%), but there was a declining trend in its constituent ratio, from 2008 to 2012. A total of 14.41% (429/2977) of patients had co-morbid conditions, 92.85% (2764/2977) used proton-pump inhibitors (PPIs) prior to endoscopic treatment, 19.65% (585/2977) underwent emergency endoscopy, and 23.45% (698/2977) received a transfusion of red blood cell suspensions. A total of 5.34% (159/2977) underwent endoscopic therapy, with a treatment rate of 16.9% in high-risk peptic ulcer patients (96/568). A total of 7.69% (237/2977) were administered aspirin, of whom 32.50% (77/237) resumed aspirin intake after gastrointestinal bleeding was controlled. The median length of hospitalization was 8 days (IQR, 5-11) and the mortality rate was 1.71% (51/2977). CONCLUSIONS Peptic ulcer was still the most common cause of NVUGIB in China. The proportion of patients with high-risk peptic ulcer bleeding who received endoscopic therapy was 16.9%. Only 19.65% of NVUGIB patients underwent emergency endoscopy.

摘要

背景

本研究通过对 2008 年至 2012 年期间 8 家医院的多中心回顾性研究,旨在发现非静脉曲张性上消化道出血(NVUGIB)的常见病因。

材料与方法

纳入年龄≥18 岁、经内镜诊断为 NVUGIB 并于 2008 年 1 月 1 日至 2012 年 12 月 31 日期间在 8 家中国医院住院的患者。采用 EpiData 软件设计问卷并开发数据录入图形用户界面。

结果

共纳入 8 家中心的 2977 例住院患者。95.47%(2842/2977)的患者入住普通病房,3.53%(105/2977)入住急诊病房,1.00%(31/2977)入住重症监护病房。消化性溃疡仍然是 NVUGIB 的最常见病因(73.26%),但其构成比呈下降趋势,从 2008 年至 2012 年。共有 14.41%(429/2977)的患者合并有其他疾病,92.85%(2764/2977)在进行内镜治疗前使用质子泵抑制剂(PPIs),19.65%(585/2977)接受急诊内镜检查,23.45%(698/2977)输注红细胞悬液。共 5.34%(159/2977)接受了内镜治疗,高危消化性溃疡患者的治疗率为 16.9%(96/568)。共有 7.69%(237/2977)服用阿司匹林,其中 32.50%(77/237)在胃肠道出血得到控制后恢复服用阿司匹林。中位住院时间为 8 天(IQR,5-11),死亡率为 1.71%(51/2977)。

结论

消化性溃疡仍然是中国 NVUGIB 的最常见病因。接受内镜治疗的高危消化性溃疡出血患者比例为 16.9%。仅 19.65%的 NVUGIB 患者接受了急诊内镜检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/571c/6187964/0f04a44c470b/medscimonit-24-7119-g001.jpg

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