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目的探讨老年人上消化道出血及导致死亡的病因。方法回顾性总结分析上消化道出血老年患者１３４例，并与同期非老年患者１２０例比较。结果老年人上消化道出血病因中主要为酸相关疾病（十二指肠溃疡、胃溃疡、胃炎、十二指肠炎、食管炎）７１例，占７３．９％；胃癌１４例，占１４．５％。发生低血压或休克，老年组１８例，非老年组８例（Ｐ＜０．０５）。使用阿司匹林或非甾体类抗炎药物，老年组２８例，显著高于非老年组（７例，Ｐ＜０．０１）。老年组死亡１８例，病死率为１３．４％，其中１５例因全身慢性疾病恶化和出血后并发症死亡；非老年组死亡６例，病死率为５．０％（Ｐ＜０．０１）。结论酸相关疾病是老年人上消化道出血的主要病因，其次为胃癌。全身慢性疾病恶化和出血后并发症是影响老年人上消化道出血预后的重要因素，特别是肺部感染、心脑血管疾病是主要的死亡原因。
Objective To investigate the causes of upper gastrointestinal bleeding and death in the elderly. Methods Retrospective analysis of 134 cases of elderly patients with upper gastrointestinal bleeding, and 120 cases of non-elderly patients with the same period compared. Results The main causes of upper gastrointestinal bleeding in the elderly were acid-related diseases (duodenal ulcer, gastric ulcer, gastritis, duodenitis and esophagitis) in 71 cases (73.9%) and gastric cancer in 14 cases (14%). 5%. Hypotension or shock occurred in 18 elderly patients and 8 non-elderly patients (P <0.05). With aspirin or non-steroidal anti-inflammatory drugs, the elderly group of 28 patients was significantly higher than the non-elderly group (7 cases, P <0.01). Elderly patients died of 18 cases, the mortality rate was 13.4%, of which 15 cases of systemic chronic disease and bleeding complications after death; 6 cases of non-elderly deaths, mortality was 5.0% (P <0.01) . Conclusion Acid-related diseases are the main cause of upper gastrointestinal bleeding in the elderly, followed by gastric cancer. Systemic chronic disease exacerbation and post-bleeding complications are important factors that affect the prognosis of upper gastrointestinal bleeding in the elderly. In particular, pulmonary infection and cardiovascular and cerebrovascular diseases are the major causes of death.