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目的 :探讨口服小剂量阿司匹林致消化道出血的临床特点及影响因素。方法 :选取我院自2005年1月~2013年12月收治入院的因口服小剂量阿司匹林致消化道出血的患者120例,选取同期收治入院的口服阿司匹林未出血的患者100例,探讨口服小剂量阿司匹林致消化道出血的临床特点及影响因素。结果 :除呕血,黑便,休克等属观察组特异性临床表现外,烧心,反酸,腹痛症状在两组间比较差异均无统计学意义。胃镜下表现中胃、十二指肠溃疡,糜烂性胃炎两组间比较差异均具有统计学意义,复合性溃疡两组比较差异无统计学意义。单因素分析结果显示吸烟比,糖尿病比,既往溃疡史,服用PPI,HP感染在两组间比较差异具有统计学意义。根据单因素分析结果,将P<0.05的因素进行多因素非条件logistic回归分析,结果显示患者糖尿病比、既往溃疡史、HP感染是独立危险因素。结论 :小剂量阿司匹林口服导致消化道出血的临床症状不典型,易被患者所忽视,伴有糖尿病,既往有溃疡史、有HP感染的患者出血可能性高,应密切观察,及早发现进行诊治。
Objective: To investigate the clinical characteristics and influencing factors of oral small dose aspirin-induced gastrointestinal bleeding. Methods: A total of 120 patients with gastrointestinal bleeding caused by oral low-dose aspirin admitted to our hospital from January 2005 to December 2013 were enrolled in this study. One hundred patients who were treated with oral aspirin without hemorrhage admitted at the same period were enrolled in this study. Aspirin - induced gastrointestinal bleeding clinical features and influencing factors. Results: In addition to hematemesis, melena, shock and other observation group is the specific clinical manifestations, heartburn, acid reflux, abdominal pain in the two groups were no significant difference between the two groups. Gastroscopy in the performance of stomach, duodenal ulcer, erosive gastritis were statistically significant differences between the two groups, the composite ulcer was no significant difference between the two groups was statistically significant. The results of univariate analysis showed that smoking, diabetes than the history of previous ulcers, taking PPI, HP infection in the two groups was statistically significant difference. According to the results of univariate analysis, the factors of P <0.05 were analyzed by multivariate non-conditional logistic regression analysis. The results showed that patients with diabetes than the previous history of ulcer, HP infection is an independent risk factor. Conclusions: The clinical symptoms of oral administration of low dose aspirin caused by gastrointestinal bleeding are not typical, easily overlooked by patients with diabetes mellitus, with previous history of ulcer. Patients with HP infection are highly likely to have bleeding and should be closely observed and diagnosed as soon as possible.