Analysis On Etiology, Causes, Endoscopic Treatment Timing And Methods Of Acute Non-variceal Upper Gastrointestinal Bleeding

Objective：1.Collected patients hospitalized data which is non-variceal uppergastrointestinal bleeding from January2004to January2014that receivedtreatment in the China-Japanese united Hospital of Jilin University,retrospectively analyze its composition of incentive, age differences andvariation in10years, providing the certificate of evidence-basedmedicine to better understand the characteristics and changes of etiologyand cause this years in the region.2.Compare different endoscopic therapy and endoscopicexamination time, aimed at choosing the best endoscopic treatmentmethod according to the different condition, and discusses the influenceof endoscopy timing on bleeding lesion detection rate, provide areference basis for clinical treatment.Methods:Collected patients hospitalized data of2306cases which is in linewith ANVUGIB clinical diagnostic criteria and well confirmed byendoscopy from January2004to January2014that received treatment inthe China-Japanese united Hospital of Jilin University, design clinicaldata registration table of ANVUGIB and record, applying SPSS17.0toanalysis.Results:1. Both elderly group and youth and middle-aged group, the mainlyetiology is peptic ulcer, elderly patients mainly with the gastric ulcer(36.6%), both the youth and middle-aged group are based on duodenalulcer., and in the elderly group, the proportion of cancer (11%) ishigher than the young group, also the anastomotic ulcer(8.0%). 2. The main cause to elderly group is the non-steroidalanti-inflammatory drugs (43.8%), significantly higher than that ofmiddle age group (12.3%) and the youth group (6.5%), P＜0.01, thedifference is statistically significant. And the main causes of youth andmiddle-aged group are drinking and emotional exhaustion, significantlyhigher than the proportion of elderly group (P <0.01, the difference isstatistically significant).3. in the decade, the proportion of peptic ulcer gradually decreased,acute gastric mucosal lesion and tumors tended to increase year by year.4. in the decade, the proportion of non-steroidal anti-inflammatorydrugs increased annually, it has become increasingly important cause ofnon-variceal upper gastrointestinal bleeding.5.≤48h emergency endoscopy group, the signs of bleeding is37.8%, higher than the proportion of>48h group (23.2%), thedifference was statistically significant.6. For patients at high-risk of Rockall score, combination therapy ismore effective (92.5%), P＜0.05, the difference was statisticallysignificant.7. For the lesions larger than2cm in diameter, combination therapyis more effective (91.1%), P＜0.05, the difference was statisticallysignificant. For the lesions less than0.5cm in diameter, clip therapy is themain treatment method.8. For the lesions of ForrestⅠa(89.7%) and ForrestⅡa(96.6%)titanium clips treatment is more effective and mainly treatment method.Conclusions:1. peptic ulcer is the most common etiology of non-variceal uppergastrointestinal bleeding followed by acute gastric mucosal lesion anddigestive system tumors, other common causes in the order is Mallory Weiss Syndrome, Deulafoy, reflux esophagitis.2. in elderly group, the main etiology is gastric ulcer, duodenal ulceris the main cause of youth and middle-aged group, and in the elderlygroup, the proportion of tumors was significantly higher than the youthgroup.3. in the decade, the proportion of peptic ulcer gradually decreased,acute gastric mucosal lesion increase significantly in recent years.4. in the decade, the proportion of non-steroidal anti-inflammatorydrugs increased annually.5. founding bleeding lesions within48hours are more easily6. For the high-risk patients of Rockall score, combination therapy ismore effective.7. For the lesions larger than2cm in diameter, combination therapyis more effective. For the lesions less than0.5cm in diameter, clip therapyis the main treatment method.8. For the lesions of Forrest Ⅰa and ForrestⅡa, titanium cliptreatment is more effective.