高寒高原地区十二指肠多发性溃疡56例分析

Analysis on 56 Patients with Multiple Duodenal Ulcers in Cold Areas at High Altitude

目的探讨空气稀薄，干燥，风沙大，平均目照时间长，紫外线强，昼夜温差大，高寒缺氧的高原（海拔2248～3500m）地区十二指肠多发性溃疡的特点。方法高寒高原地区部队官兵及其家属行内窥镜检查817例，设为检查组（A组），检出十二指肠多发性溃疡56例，其中男忡49例，女性7例。选择云南开远和广东肇庆地区730例，作为对照组（B组）多发性溃疡30例，其中男性21例，女性9例。结果通过分析高原高寒地区十二指肠溃疡的发病原因，主要是：（1）饮酒和服用解热镇痛剂；（2）服用抗生素；（3）溃疡好发部位在十一指肠球部前壁和球后壁，溃疡面形态以圆形多见；（4）溃疡伴上消化道出血较多，发生率为30，36％，较B组发生率26．67％稍高；（5）在56例十二指肠多绂性溃疡中恶性溃疡少见。结论高原高寒地区十二指肠多发性溃疡发病率略高于内地。

Objective To investigate the characteristics of multiplc duodenal ulcers in the cold areas at high altitude. Methods Group A, including 817 servicemen and their family members living in the cold areas at high altitude （2,248-3,500 meters above sea level） , was examined via endoscopy, and 56 patients consisting of 49 males and seven females were found to suffer from muhipie duodenal ulcers. Another 730 examinees （from Kaiyuan, Yunnan province and Zhaoqing, Guangdong province） were enrolled into Group B （control group） , in which there were 30 patients （21 males, nine females） ill with multiple duodenal ulcers. Results （ 1 ） the main pathogenic causes were drinking and taking pain-killer or antipyretic; （2） taking antibiotics was another cause; （3） it was easy to locate the ulcer location, i.e. mainly in the front and back walls of duodenal ball, and the ulcer shapes were mostly rolmded; （4） the ulcers accompanied by the upper digestive tract bleeding were common, and occurrence rates were 30.36% in the patients from Group A and 26.67% in those from Group B; （5） malignant ulcer was rare in the 56 patients with multiple duodenal ulcers from Group A. Conclusion The occurrence rate of multiple duodenal ulcers is slight higher in the cold areas at high altitude than in the inlands.