摘要
目的探讨老年消化性溃疡（ＰＵＡ）的临床及内镜下特点．方法１９８５－１９９４年６０岁以上消化性溃疡（ＰＵ）住院患者２２２例，以同期６０岁以下ＰＵ１００例为对照进行临床内镜分析．结果老年胃溃疡占同期胃溃疡住院人数的构成比已由１９８５年的１０９％递增至１９９４年的２４０％．ＰＵＡ上腹痛、节律性腹痛、反酸、烧心症状发生率依次为５７８％，２２５％，３１５％和１０４％，对照组依次为８７０％，４５０％，４８０％和３８０％（Ｐ＜００１）．并发症发生率ＰＵＡ组为６０８％，对照组为４００％（Ｐ＜００１）．ＰＵＡ直径大于３ｃｍ者占２２５％，对照组为４０％（Ｐ＜００１）．行手术治疗者ＰＵＡ组为２１６％，对照组为１１０％（Ｐ＜００１）．结论ＰＵＡ临床症状不典型，并发症发生率高，巨大溃疡常见，出血难止。
AIM To analyse the clinical and gastroscopic features of peptic ulcer in the aged (PUA). METHODS 222 hospitalized patients with peptic ulcer, aged over 60 were analysed from 1985 to 1994, and 100 patients with peptic ulcer hospitalized at the same period under the age of 60 served as controls. RESULTS The ratio of the gastric ulcer (GU) in the aged to the GU in all age group was gradually increased from 10 9% in 1985 to 24 0% in 1994. The occurrence rates of upper abdominal pain, rhythmical abdominal pain, regurgitation, sour and heartburn in PUA in the aged were 57 8%, 22 5%, 31 5% and 10 4%, respectively, whereas those in the control group were 87 0%, 45 0%, 48 0% and 38 0%, with significant differences between the two groups (P<0 01). Moreover, the occurrence rate of complications of PUA in the aged was 60 8%, whereas that of control group was 40 0% (P<0 01). The large ulcers with a diameter of more than 3cm covered 22 5% of all cases of GU in the aged, whereas it was 4 0% in the controls (P<0 01). The operation rate of PUA in the aged was 21 6%, whereas it was only 11 0% in the controls (P<0 01). CONCLUSION PUA in the aged has the following features: atypical clinical manifestations, high occurrence rates of complications, more giant ulcer hemorrhage and difficult to be controlled and more operations required.
