老年与中青年消化性溃疡临床特点比较(附815例分析)  

Comparison of Clinical Characteristics of Peptic Ulcer in Young and Elderly Patients(815 cases analysis)

作　　者：张恒涛 王兴双 黄进[3] 

机构地区：[1]兰州军区临潼疗养院附属医院内科 [2]解放军68310部队门诊部 [3]第四军医大学唐都医院消化内科

出　　处：《临床误诊误治》2013年第1期75-78,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的分析并比较老年与中青年消化性溃疡的临床特点,以提高临床诊治水平。方法回顾分析2008年2月—2010年11月在我院经胃镜+活检及手术病理检查确诊的老年消化性溃疡385例(老年组)与430例中青年消化性溃疡(中青年组)的临床资料,比较两组的病因、临床表现、溃疡特点、并发症、治疗及预后。结果老年组与中青年组在长期服用非甾体抗炎药(35.3%vs 8.6%)、典型节律性腹痛(20.5%vs 42.7%)、无症状者比例(31.9%vs 11.2%)、高位胃溃疡(15.8%vs 4.9%)、巨大溃疡(23.4%vs 5.8%)、并发症发生率(56.1%vs 24.7%)等方面比较差异均有统计学意义(P均<0.05)。两组经幽门螺杆菌(Hp)根除治疗后疼痛缓解时间及病死率比较差异亦有统计学意义(P均<0.05),Hp感染率及Hp根除率比较差异无统计学意义(P>0.05)。结论老年人消化性溃疡临床表现多不典型,高位溃疡、巨大溃疡、并发症发生率较高,且治疗效果欠佳,易发生癌变,临床应予以重视。Objective To analyze and compare the clinical characteristics of peptic ulcer in young and elderly patients in order to improve diagnosis and treatment.Methods Clinical data of 385 elderly patients with peptic ulcer(the older group) and 430 young or middle aged patients with peptic ulcer(young group) diagnosed by means of endoscopy + biopsy and operation during February 2008 and November 2010 in our hospital were retrospectively analyzed,and the causes of the disease,clinical manifestations,features,complications,treatment effectiveness and prognosis of the two groups were compared.Results The differences in long-term administration of nonsteroidal anti-inflammatory drugs(35.3% vs 8.6%),the typical rhythmic abdominal pain(20.5% vs 42.7%),asymptomatic ratio(31.9% vs 11.2%),high gastric ulcer(15.8% vs 4.9%),giant ulcer(23.4% vs 5.8%) and complications incidence rate(56.1% vs 24.7%) of elderly and young and middle-aged patients were statistically significant(average P<0.05).The differences in pain relief time and fatality rates of the two groups after eradication therapy with the helicobacter pylori(Hp) were statistically significant(average P<0.05).The differences in infection rate and eradicate rate of Hp was not statistically significant(P>0.05).Conclusion The clinical manifestations of peptic ulcer in elder patients are not typical.They have a higher rate of complications and lower rate of efficacy but a tendency of high ulcer,giant ulcer and canceration.

关 键 词：老年人 中青年 消化性溃疡 疾病特征 对比研究 

分 类 号：R573.1[医药卫生—消化系统]