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目的：探讨老年人上消化道出血急诊内镜处理的价值和安全性。方法：老年组上消化道出血２８３例，有并存病１４４例占５０．９％，中青年组８９２例行急诊内镜处理。术中监测心脑肺功能，控制心衰、呼衰、血压、心律失常，纠正休克。判断出血病因分别镜下套扎、注射、喷洒药物止血。结果：老年组包括有严重并存病不能耐受麻醉及手术者均安全接受急诊内镜处理。出血病因以消化溃疡为首位，胃癌、胃溃疡、Ｄｉｅｕｌａｆｏｙ病高于中青年组。活动性出血１１８例经镜下止血，１１０例立即止血，急诊止血率９３．２％，与中青年组无差异（Ｐ＞０．０５）。结论：急诊内镜是明确老年人出血病因的首选方法。镜下止血安全可靠，适合老年人特别是有严重并存病不能耐受手术者。
Objective: To investigate the value and safety of emergency endoscopic treatment of upper gastrointestinal bleeding in the elderly. Methods: 283 cases of upper gastrointestinal bleeding in the elderly group, 144 cases of comorbidity accounted for 50.9%, 892 cases of young and middle-aged patients underwent emergency endoscopy. Intraoperative monitoring of heart and brain function, heart failure, respiratory failure, blood pressure, arrhythmia, correct shock. To determine the cause of bleeding were mirror ligation, injection, spraying drugs to stop bleeding. Results: The elderly group, including patients with severe concurrent disease can not tolerate anesthesia and surgery were safely received emergency endoscopic treatment. The cause of bleeding was peptic ulcer, gastric cancer, gastric ulcer and Dieulafoy disease were higher than those in middle-aged and young people. Active hemorrhage 118 cases under the hemostasis, 110 cases of immediate hemostasis, emergency bleeding rate was 93.2%, no difference with the young group (P> 0.05). Conclusion: Emergency endoscopy is the first choice of the etiology of senile hemorrhage. Microscopic hemostasis safe and reliable, suitable for the elderly, especially those with serious coexisting disease can not tolerate surgery.