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目的 探讨老年人上消化道出血病因分布特点及急诊胃镜检查和治疗的价值。方法 对１９８８～１９９７年１１０１例以呕血和（或）黑便为表现的老年人急诊胃镜检查资料及９８例胃镜止血资料进行分析。结果 老年人上消化道出血病因主要为消化性溃疡７８３例（７１．１％），胃癌１１４例（１０．２％），门脉高压症５０例（４．５％）等。９８例患者施行了内镜下止血，其即刻止血率前三位如下：消化性溃疡伴活动性出血为９１．９％，食管静脉曲张破裂出血９２．３％，胃癌伴活动性出血８３．３％。３例贲门粘膜撕裂症及１例胃多发性息肉伴活动性出血即刻止血均成功。为预防再出血，１３例消化性溃疡伴新近出血的患者也施行了胃镜下止血治疗。急诊胃镜检查和胃镜下止血治疗未引起心、肺、脑等系统的并发症。结论消化性溃疡和胃癌是老年人上消化道出血的主要原因，急诊胃镜检查有利于早期诊断、合理治疗。急诊胃镜止血疗效可靠，二者均安全可行。消化性溃疡和胃癌伴活动性出血急诊胃镜止血率分别为９１．９％及８３．３％。
Objective To investigate the etiology and distribution of upper gastrointestinal bleeding and the value of emergency endoscopy and treatment in the elderly. Methods A total of 1101 elderly patients with hematemesis and / or melena (1988) were enrolled in this study. The data of emergency gastroscopy and 98 cases of gastroscopic hemostasis were analyzed. Results The main causes of upper gastrointestinal bleeding in the elderly were 783 cases (71.1%) with peptic ulcer, 114 cases (10.2%) with gastric cancer, and 50 cases (4.5%) with portal hypertension. 98 cases of patients underwent endoscopic hemostasis, the first three immediate hemostasis as follows: peptic ulcer with active bleeding was 91.9%, esophageal variceal bleeding was 92.3%, gastric cancer with active bleeding 83.3 %. 3 cases of cardial mucosal tear and 1 case of gastric polyps with active bleeding hemostasis were successful. To prevent rebleeding, 13 patients with peptic ulcer associated with recent hemorrhage were also treated with endoscopic hemostasis. Emergency gastroscopy and endoscopic hemostasis did not cause heart, lung, brain and other complications. Conclusions Peptic ulcer and gastric cancer are the main causes of upper gastrointestinal bleeding in the elderly. Emergency gastroscopy is good for early diagnosis and reasonable treatment. Emergency gastroscope to stop bleeding is reliable and both are safe and feasible. Peptic ulcer and gastric cancer with active bleeding emergency gastrostomy rates were 91.9% and 83.3%.