Upper gastrointestinal hemorrhage in patients with peptic ulcer: Risk factors and treatment

Abstract

AIM To investigate the clinical features, risk factors, and treatment of peptic ulcer (PU) combined with upper gastrointestinal hemorrhage. METHODS One hundred and sixty patients with PU combined with upper gastrointestinal hemorrhage treated at Wuxing District People’s Hospital of Huzhou from February 2016 to December 2017 were selected as an observation group, and 160 PU patients without upper gastrointestinal hemorrhage were selected as a control group. The clinical features and risk factors for PU combined with upper gastrointestinal hemorrhage were then analyzed. The patients with PU combined with upper gastrointestinal hemorrhage were then divided into two groups according to treatment method: those given basic treatment and proton pump inhibitor triple therapy (group A, n = 84) and those receiving basic treatment, endoscopic batroxobin, and proton pump inhibitor triple therapy(group B, n = 76). The clinical efficacy, blood transfusion volume after 3 d, rebleeding rate, and incidence of adverse reactions during treatment were compared between the two groups. The eradication rate of Helicobacter pylori (H. pylori) after 30 d of treatment was also recorded. RESULTS Main clinical manifestations of the patients with PU combined with upper gastrointestinal hemorrhage were melena, hematemesis, and melena combined with hematemesis, usually with dizziness. The bleeding volume was less than 500 mL in most of the patients. Drinking, smoking, onset in autumn and winter, male gender, use of non-steroidal anti-inflammatory drugs (NSAIDs), gastric ulcer, complex ulcer, and ulcer duration ≥ 6 mo were risk factors for PU combined with upper gastrointestinal hemorrhage. The total effective rate and H. pylori eradication rate were significantly lower in group A than in group B, while the rebleeding rate and blood transfusion volume were significantly higher in group A than in group B (P < 0.05). CONCLUSION Unhealthy living habits, male gender, use of NSAIDs, gastric ulcer, complex ulcer, and ulcer duration ≥ 6 mo are high risk factors for PU combined with upper gastrointestinal hemorrhage. Endoscopic interventional treatment combined with proton pump inhibitor triple therapy is safe and reliable in the treatment of PU combined with upper gastrointestinal hemorrhage.