老年消化性溃疡57例临床特点分析

An analysis of the clinic features of the aged peptic ulcer

目的探讨老年性消化溃疡的临床特点,以指导治疗、预防并发症.方法我院2001～2004年共行电子胃镜检查4 276例,共检出消化性溃疡337例,其中老年性消化性溃疡57例,占17.2%.对57例老年性消化道溃疡临床特点进行分析,并与同期非老年组进行比较.结果（1）多数病例缺乏典型的上腹部节律性疼痛和周期性发作,而以上腹部不适、腹胀、呃逆、纳差、嗳气等症状较明显突出,因此对不典型症状老年人应行胃镜检查,以便明确诊断,及时治疗;（2）部分患者治疗症状缓解不明显,延长治疗时间可提高疗效.（3）老年组幽门螺旋杆菌（HP）感染率低于非老年组;胃溃疡高于十二指肠球溃疡.消化道出血、穿孔、幽门梗阻、癌变等并发症高于非老年组.结论老年消化性溃疡具有临床症状表现不典型,病程较长且并发症多,伴随疾病及病死率高等方面特点,临床上应引起高度重视.

Objective To explore the clinic features of peptic ulcer in order to direct the therapy and prevent complications. Methods 4 276 cases who took the electronic gostroscope from 1 January 2001 to 30 December 2004 were retrospectively studied and compared with control group. Results Firstly, in most cases typical regularity of pain and periodicity of bout were not obvious so the aged who had no typical symptoms should be given the gastroscope check so that we could diagnose and therapy them in time. Seeordly, in some cases （≥60 years） the thrapeutic effects were not ideal. If prolonging the therapeutic time, we could improve the effect. Thirdly, the infecting rate of HP was lower than the control group but the rate of complications such as bleeding, perforation, pyloric stenosis and canceration was higher. Conclusion The aged peptic ulcer has no typical symptoms, but is characteristic of the longer period, more complications and high death rate. So we should pay high attention to it in clinic.