| Objective: to analyze the relationship between clinical features and rebleeding within one year in adult patients with gastrointestinal bleeding.Methods: Choose between January 2012 and December 2016,the first people’s hospital in xianyang digestive internal medicine,347 cases of adult patients with gastrointestinal bleeding in hospital as the research object,and excluded those who were due to return when the phone went unanswered,transferred to the surgical operations and other patients lost to follow-up,a total of 49 cases,clinical data of 298 cases with gastrointestinal bleeding in adult patients were retrospectively analyzed.Analysis of the causes of bleeding;Univariate and multivariate analyses were performed for age,sex,nonsteroidal anti-inflammatory drugs,proton pump inhibitors,and area to determine the risk factors for rebleeding within 1 year.Results:1.among 298 adult patients with gastrointestinal bleeding,170(57.0%,170/298)were male,128(43%,128/298)were female,and 28(16.5%,28/170)were rebleeding within one year.There were 24 female patients with rebleeding within one year(18.8%,24/128).147 patients(49.3%,147/298)were aged ≥ 60 years old,151cases(50.7%,251/298)were aged < 60 years old,and 32 cases(21.8%,32/147)were rebleeding within one year of age ≥ 60 years old.There were 20 patients(13.2%,20/151)with rebleeding within 1 year of age < 60 years old(13.2%,20 / 298).128 cases(43%,128 /298)in rural areas,170 cases(57.0%,170/298)in urban areas,18 cases(14.1%,18/128)in rural areas and 34 cases(20%,34/170)in urban areas in one year.34 / 298);There were 110 patients(36.9%,110/298)with NASIDs,188patients(63.1%,188/298)without NASIDs,and 30 patients(27.3%,30/110)with nsaids1 rebleeding during the year.There were 22 patients(11.7%,22 /298)who did not take NASIDs for rebleeding during the year.188 patients(63.1%,188/298)with PPIs,110 patients(37.0%,110/298)without PPIs,19 patients(10.1%,19/188)with rebleeding within 1 year with PPIs.There were 33 patients with rebleeding within 1year without PPIs administration(30%,33/110).125 cases(41.9%,125/298)were treated by endoscopy,173 cases(58.1%,173/298)with drug therapy,and 16 cases(12.8%,16 /298)with rebleeding within one year of endoscopic treatment.36 patients(20.1%,36/173)had rebleeding within one year of drug treatment.2 peptic ulcer was the most common cause of gastrointestinal bleeding(92%,30.9%).3 the incidence of rebleeding within 1 year in patients taking NASIDs was significantly higher than that in patients without NASIDs within 1 year.(or=2.530,95%ci(1.058,6.051),P ≤0.037);The incidence of rebleeding within 1 year in patients without PPIs was significantly higher than that in patients taking PPIs within 1 year(or=3.703,95%ci(1.216,11.273),p ≤ 0.021).The incidence of rebleeding in urban patients within one year was not significantly higher than that in rural patients within one year(or=2.867,95%ci(0.967,8.501),p ≤ 0.050).There was no significant difference in the incidence of rebleeding within 1 year between patients aged less than 60 years and those aged ≥ 60 years(or=1.339,95%ci(0.393,4.564),p ≤ 0.641).The incidence of rebleeding in male patients within one year was not significantly higher than that in female patients within 1 year(or=0.652,95%ci(0.282,1.508),p ≤ 0.318).Conclusion:1.The most common cause of gastrointestinal bleeding in adults is peptic ulcer.2.The application of nsaids and the absence of ppis are important risk factors for rebleeding within one year. |
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