老年人上消化道出血特点－孙为豪.ppt 1,934KB.ppt
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Characteristic of upper gastrointestinal bleeding
among geriatric patients
Criteria of WHO
* elderly individual: those over 65 years of age
* elderly society: It is more than 7% that the percentage ratio of elderly population to total population in the area or a country.
Epidemiology
* 103:100 000 adults per year
* Shift in age of population at risk
* Increasing use of NSAIDs & anticoagulants
* Increasing incidence of in-hospital bleeding
Aetiology
* PUD 50%
* Acute gastric erosions 20%
* Esophageal varices 10%
* Tumor 5%-10%
* AVM 6%
* Mallory-Weiss tear 5%
* Deiulafoy 1%
VIGOR - Summary of GI Endpoints
"Modern" Management of
UGI Hemorrhage
* Resuscitation
* High dose proton pump inhibitors
80 mg bolus injection of omeprazole plus 8 mg/hr infusion
* Early endoscopy with therapeutic intervention
* Repeat endoscopy in 2 hours for high risk patients
Conclusion
Majority of the patients with acute UGI bleed are high risk elderly patients and should undergo the minimum operation to secure haemostasis at the first sign of clinical re-bleed following therapeutic endoscopy.
Characteristic of upper gastrointestinal bleeding
among geriatric patients
Criteria of WHO
* elderly individual: those over 65 years of age
* elderly society: It is more than 7% that the percentage ratio of elderly population to total population in the area or a country.
Epidemiology
* 103:100 000 adults per year
* Shift in age of population at risk
* Increasing use of NSAIDs & anticoagulants
* Increasing incidence of in-hospital bleeding
Aetiology
* PUD 50%
* Acute gastric erosions 20%
* Esophageal varices 10%
* Tumor 5%-10%
* AVM 6%
* Mallory-Weiss tear 5%
* Deiulafoy 1%
VIGOR - Summary of GI Endpoints
"Modern" Management of
UGI Hemorrhage
* Resuscitation
* High dose proton pump inhibitors
80 mg bolus injection of omeprazole plus 8 mg/hr infusion
* Early endoscopy with therapeutic intervention
* Repeat endoscopy in 2 hours for high risk patients
Conclusion
Majority of the patients with acute UGI bleed are high risk elderly patients and should undergo the minimum operation to secure haemostasis at the first sign of clinical re-bleed following therapeutic endoscopy.
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