非甾体抗炎药相关性上消化道出血的临床及胃镜特征观察

屈宽顺

（洛川县医院消化内科，陕西 延安，727400）

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摘要：

目的 探讨非甾体抗炎药相关性上消化道出血的临床及胃镜特征。方法 选择我院收治的50 例非甾体抗炎药相关性上消化道出血患者为观察组，将同期580 例溃疡、黏膜糜烂出血的患者作为对照组。统计观察组对非甾体抗炎药的应用情况。比较两组患者的临床及胃镜特征。结果 应用非甾体抗炎药防治心脑血管疾病服药27 例，主要为阿司匹林；治疗关节痛10 例，包括双氯芬酸钠、吲哚美辛、布洛芬；治疗感冒等8 例，服用感冒胶囊（含扑热息痛）及氨基比林；服用2 种或2 种以上非甾体抗炎药5 例。观察组临床特征中无消化系统症状、年龄≥60 岁、血红蛋白≥10 g/L、住院时间<14 d、存活的占比均高于对照组（P<0.05）；胃镜检查过程中病变性质的糜烂性、多发、胃部、Hp 阳性发生率高于对照组（P<0.05）。结论 非甾体抗炎药相关性上消化道出血患者典型消化道症状相对较少，以年龄≥60 岁Hp 阳性患者高发，且患者的血红蛋白影响较小，停药后
可较快痊愈；胃镜检查特征表现为黏膜糜烂、浅表溃疡以及出血症状。临床上应采取相应的措施避免及减少患者非甾体抗炎药相关性上消化道出血的发生。

关键词：非甾体抗炎药；上消化道出血；胃镜

中图分类号：R573.2 文献标志码：A文章编号：2096-1413(2018)05-0119-02

Clinical and gastroscopic features of upper gastrointestinal bleeding associated with nonsteroidal antiinflammatory drugs
QU Kuan-shun
(Gastroenterology Department, the Hospital of Luochuan County, Yan``an 727400, China)

ABSTRACT: Objective To explore the clinical and gastroscopic features of upper gastrointestinal bleeding associated with nonsteroidal antiinflammatory drugs (NSAIDs). Methods Fifty patients with upper gastrointestinal bleeding associated with NSAIDs admitted in our hospital were selected as the observation group; in the same period, 580 patients with ulceration and mucosal erosion hemorrhage were selected as the control group. The application of NSAIDs in the observation group was observed. The clinical and gastroscopic features of the two groups were compared. Results There were 27 cases of preventing cardiovascular and cerebrovascular diseases with NSAIDs, main aspirin; 10 cases of treating joint pain, including diclofenac sodium, indomethacin and ibuprofen; 8 cases of treating colds, with cold capsules (including paracetamol) and aminopyrine; 5 cases of using two or more kinds of NSAIDs. The proportion of clinical features (the symptoms of no digestive system, the age older than 60 years old, the level of hemoglobin more than 10 g/L, the hospitalization time less than 14 d and survival) in the observation group were higher than those in the control group (P<0.05). In the check of gastroscopy, the rate of the lesion properties (erosive lesions, stomach and HP positive) in the observation group were higher than those in the control group (P <0.05). Conclusion The typical gastrointestinal symptoms of patients with upper gastrointestinal bleeding associated with NSAIDs are relatively small, the patients whose age is ≥60-year -old, HP-positive have high incidence, hemoglobin in patients with less effect, and patients will be cured more quickly after stopping taking drugs. Gastroscopic features showed mucosal erosion, superficial ulcers and bleeding symptoms. Corresponding measures to avoid and reduce the incidence of upper gastrointestinal bleeding associated with NSAIDs should be taken in clinic.
KEYWORDS: nonsteroidal antiinflammatory drugs (NSAIDs); upper gastrointestinal bleeding; gastroscopy

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