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頁籤選單縮合
題 名 | Risk Factors of Upper Gastrointestinal Bleeding in Patients Hospitalized in a Chronic Ward=慢性病房住院病患上消化道出血之危險因子 |
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作 者 | 林志陵; 陳冠仰; 林光洋; 柯富聰; 李育賢; 王鐘貴; | 書刊名 | 北市醫學雜誌 |
卷 期 | 10:1 2013.03[民102.03] |
頁 次 | 頁1-9 |
分類號 | 415.5 |
關鍵詞 | 上消化道出血; 食道炎; 食道潰瘍; 鼻胃管; Upper gastrointestinal bleeding; Esophagitis; Esophageal ulcer; Naso-gastric tube; |
語 文 | 英文(English) |
中文摘要 | 需要長期照護之慢性病房住院病患中,上消化道出血是最常見的併發症之一。藉由此一回顧性研究,我們分析在慢性病房住院病患發生上消化道出血的臨床特點。方法:收集市立聯合醫院仁愛院區慢性病房住院病患173例,含發生上消化道出血病患109例及無上消化道出血病患64例。將兩組病患之臨床特點及病程進行比較。結果:有135(78.0%)病患需要長期鼻胃管灌食。發生上消化道出血的病患置放鼻胃管的比例明顯高於無上消化道出血的病患(89.9% vs. 57.8%, P<0.001)。12位具有尿毒症共病的病患均發生上消化道出血。經由多變項分析顯示鼻胃管及糖尿病共病是病患發生上消化道出血的獨立危險因子(勝算比分別為 6.19; 95% CI, 2.69-14.21, P<0.001和2.63; 95% CI, 1.16-5.96, P=0.021)。53例接受上消化道內視鏡檢查,發現75個上消化道出血相關性病灶。其中食道炎或食道潰瘍是上消化道出血最常見的原因(36%)。本研究中總死亡率為50.3%。然而,只有3.5%的患者死於無法控制的上消化道出血。結論:慢性病患者常併發上消化道出血。鼻胃管的置放、尿毒症和糖尿病共病是上消化道出血的相關危險因子。食道炎或食道潰瘍是接受鼻胃管灌食病患發生上消化道出血最常見的原因。 |
英文摘要 | Upper gastrointestinal (UGI) bleeding is one of the most frequent complications among patients who need long-term care in a chronic ward. In this retrospective study, we therefore investigated the characteristics of UGI bleeding among patients hospitalized on a chronic ward. Methods: A total of 173 patients admitted to the chronic ward of the Ren-Ai Branch, Taipei City Hospital, were retrospectively enrolled. These individuals consisted of 109 patients with UGI bleeding and 64 patients without UGI bleeding. The demographic data and clinical courses of these patients were compared. Results: There were 135 (78.0%) patients who needed long-term naso-gastric (NG) tube feeding. Patients with UGI bleeding had a significantly higher rate of NG tube placement than those without UGI bleeding (89.9% vs. 57.8%, p<0.001). All 12 patients with uremia suffered from UGI bleeding. In addition, the presence of a NG tube (odds ratio, 6.19; 95% CI, 2.69-14.21, p<0.001) and the presence of diabetes mellitus as a comorbidity (odds ratio, 2.63; 95% CI, 1.16-5.96, p=0.021) were independent risk factors associated with UGI bleeding. A total of 75 UGI bleeding associated lesions were observed among 53 patients who underwent upper gastrointestinal endoscopy. Esophagitis or an esophageal ulcer was the most frequent causes of UGI bleeding (36%). The overall mortality rate was 50.3%. However, only 3.5% of the patients died from uncontrolled bleeding. Conclusions: UGI bleeding occurs frequently in patients with chronic illness. The presence of a NG tube, uremia as a comorbidity and diabetes mellitus as a comorbidity were found to be risk factors associated with UGI bleeding. The most common source of UGI bleeding in patients who were undergoing NG tube feeding was esophagitis and/or esophageal ulcer. |
本系統中英文摘要資訊取自各篇刊載內容。