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外科研究与新技术（中英文）

外科研究与新技术 ›› 2017, Vol. 6 ›› Issue (3): 158-161.doi: 10.3969/j.issn.2095-378X.2017.03.004

• 论著 • 上一篇    下一篇

老年消化性溃疡临床与胃镜特点分析

张东伟, 杨长青   

  1. 同济大学附属同济医院消化内科,上海 200065
  • 收稿日期:2017-05-19 发布日期:2019-12-11
  • 通讯作者: 杨长青,电子信箱:cqyang@tongji.edu.cn
  • 作者简介:张东伟(1964—),男,主任医师,从事消化内科

Analysis on clinical characteristics and gastroscopy results of elderly patients with peptic ulcer

ZHANG Dongwei, YANG Changqing   

  1. Department of Gastroenterology,Tongji Hospital Affiliated to Tongji University, Shanghai 200065,China
  • Received:2017-05-19 Published:2019-12-11

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摘要： 目的 探讨老年患者消化性溃疡的临床与胃镜特点,为诊断和治疗提供依据。方法 回顾性分析2011年 1月—2016年12月住院治疗的老年消化性溃疡患者187 例和非老年消化性溃疡患者239例,对比分析其临床表现与内镜特点。结果 老年患者消化性溃疡临床症状不典型,以呕血/黑便为首发症状,而非老年组患者则为典型节律性疼痛;老年患者发病诱因主要是饮酒和服用非甾体类抗炎药,与非老年组比较,差异均有统计学意义(P<0.001);老年患者以胃溃疡多见,非老年患者以十二指肠球部溃疡多见,二者比较差异有统计学意义(P<0.001);老年患者胃溃疡和十二指肠球部溃疡直径大于2 cm的溃疡较非老年患者明显增高,二者比较差异有统计学意义(P<0.001)。结论 老年患者消化性溃疡临床症状多不典型,其病变部位、病变大小和常见发病诱因与非老年患者均存在显著差异,对老年患者消化性溃疡需要进行针对性诊断与治疗。

关键词: 老年, 消化性溃汤, 胃镜检查

Abstract: Objective To investigate the clinical and gastroscopic features of peptic ulcer in the elderly,and to provide a basis for relevant diagnosis and treatment.Methods A total of 187 elderly cases with peptic ulcer and 239 control cases from January 2011 to December 2016 were enrolled in this study.Their clinical manifestations and gastroscopic results were analyzed.Results The clinical symptoms of the elderly cases with peptic ulcer were not typical,showing first signs of haematemesis and melena,while the controls showed typical symptoms.Drinking and taking nonsteroids anti-inflammatory drugs(NSAIDs) were the risk factors for peptic ulcer of the elderly patients,and there were significant differences in the rates of drinking and taking NSAIDs between the two groups (P<0.001).The elderly patients reported more gastic ulcers,the controls reported more duodenal ulcers,and there were significant differences in the incidence rates of the two diseases (P<0.001).A higher rate of large ulcers (diameter>2 cm) was found in the elderly patients than in the controls,and the difference was significant (P<0.001).Conclusion The clinical symptoms of peptic ulcer are not typical in the elderly patients.There are significant differences between the elderly patients and controls in lesion site,lesion size,and risk factors.Targeted diagnosis and treatment of peptic ulcer are required for the elderly.

Key words: Elderly people, Peptic ulcer, Gastroscopy

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