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目的:总结口服小剂量阿司匹林(Aspirin,ASP)诱发上消化道出血的临床特点及防治对策。方法:调查同期非食道静脉曲张性上消化道出血患者380例(402例次),根据出血前是否正在服用ASP分为两组:ASP组38例(出血42例次)与非ASP组342例(出血364例次),回顾性分析两组间的临床特点。结果:ASP组上消化道出血患者,平均年龄(64.5±5.4)岁,高于非ASP组(43.5±16.5岁),胃溃疡和胃黏膜病变的发生比例(69.1%)高于非ASP组(26.70%)(P<0.01),57.1%的患者出血前有诱因。出血量、Hb两组间无差异,止血时间(平均3.7d)长于非ASP组(平均2.3d)(P<0.05)。结论:口服小剂量ASP是老年患者上消化道出血的主要原因之一,其中胃部病变发生比率较高,止血所需时间较长,口服ASP时加强胃粘膜的保护、控制诱因有望预防上消化道出血的发生。
Objective: To summarize the clinical features and prevention and cure strategies of oral small dose aspirin (ASP) induced upper gastrointestinal bleeding. Methods: 380 patients (402 cases) with non-esophageal varices hemorrhage during the same period were investigated. According to whether they were taking ASP before bleeding, 38 cases (42 cases of bleeding) in ASP group and 342 cases in non-ASP group (364 episodes of bleeding), and retrospectively analyzed the clinical features of the two groups. Results: The average age of patients with upper gastrointestinal bleeding in ASP group (64.5 ± 5.4) years was higher than that of non-ASP group (43.5 ± 16.5 years), and the incidence of gastric ulcer and gastric mucosal lesion was 69.1% 26.70%) (P <0.01), 57.1% of patients had incentives before bleeding. The amount of bleeding and Hb had no difference between the two groups. The bleeding time (mean 3.7 days) was longer than that of non-ASP group (average 2.3 days) (P <0.05). Conclusion: Oral low dose ASP is one of the main causes of upper gastrointestinal bleeding in elderly patients. The gastric lesion occurrence rate is high, the time required for hemostasis is longer, and the protection of gastric mucosa is strengthened when oral ASP is administered. Road bleeding occurs.