老年人难治性胃溃疡45例临床分析  

Clinical characteristics and therapeutic effect of refractory gastric ulcer in elderly patients

作　　者：滕小军[1] 刘荣[1] 贺降福[1] 沈志祥[2] 

机构地区：[1]湖北省黄石市第五人民医院消化科黄石市消化病防治研究所,湖北黄石435005 [2]武汉大学人民医院消化科

出　　处：《胃肠病学和肝病学杂志》2009年第12期1121-1124,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨老年人难治性溃疡形成的原因、临床表现、病理特征及治疗效果。方法分析我院2000年1月~2006年12月间年龄≥60岁胃溃疡患者的临床资料,根据标准抗溃疡病治疗12周后的疗效分为难治组及有效组,比较两组间的临床病理特征,并观察难治组患者继续治疗的疗效。结果共有387例患者纳入本研究,其中难治组45例,有效组342例。在难治组中抑郁症患者26.7%、巨大溃疡发生率28.9%、并发症66.7%、霉菌的感染率20.0%,均显著高于有效组。两组在年龄、性别、幽门螺旋杆菌（H.pylori）感染率、溃疡部位、溃疡的病理改变、吸烟与饮酒等方面的差异均无显著性（P〉0.05）。难治组H.pylori根治率显著低于有效组（52.0%vs82.6%,P〈0.05）。45例老年人难治性胃溃疡患者经过对因治疗,总有效率为31.1%（14/45）。结论老年人难治性胃溃疡原因众多、机制复杂、疗效较差,需要采取综合措施以提高治愈率。Objective To study the clinical characteristics and therapeutic effect of refractory gastric ulcer in elderly patients. Methods Elderly patients with gastric ulcer from Jan, 2000 to Dee, 2006 were divided into two groups （refractory group and effective group） according to therapeutic effect after 12-week standard treatment. Patients in refracto- ry group were continuously treated and followed-up for 12-week. Results Three hundred and eighty seven patients were divided into two groups ： 45 cases in refraetory group and 342 cases in effective group according to the their answer to the treatments. There were no significant differences in sex, age, infective rate of H. pylori, the location of ulcer, smoking and alcohol consumption, and the pathological changes of ulcer between two groups. However, patients in refractory group had more depression cases （26.7% vs 12.3%, P 〈0.05）, huge size ulcer （28.9% vs 10.5%, P 〈0.01）, complications （66.7% vs 36.5% , P 〈0.05） , and fungal infection （20.0% rs 5.3% , P 〈0.01） compared to the effective group. The H. pylori eradication rate in refractory group was significantly lower than that in effective group （52.0% vs 82.6% , P 〈 0.05 ）. The effective rate was 31.1% （ 14/45 ） after another 12-week treatment on patients in refractory group. Conclusion Comprehensive measures should be taken to elevate the effective rate of refractory gastric ulcer in elderly people because of various pathogens, complicated mechanisms, and bad therapeutic effects.

关 键 词：老年人 胃溃疡 难治性 

分 类 号：R573.1[医药卫生—消化系统]