老年人与中青年人消化性溃疡的临床比较分析

Comparative Analysis on Clinical Features of Peptic Ulcer in People of Different Age Groups

目的对不同年龄的消化性溃疡作分析,以提高对该病的诊治水平。方法将331例溃疡患者分2组,老年组129例、中青年组202例,就不良影响因素、主要临床症状、溃疡灶部位,幽门螺杆菌检测、并发症和伴发病等进行比较分析。结果长期吸烟、饮酒、服用NSAIDs者在2组比例居高;35.6%老年人临床症状不典型;胃溃疡老年组34.8%高于中青年组17.3%(P<0.01);穿孔在中青年人多见,上消化道出血是老年人主要并发症之一;过半数以上老年人溃疡伴发三种及以上慢性疾病。结论不同年龄的溃疡病特点各异,老年人溃疡病以不典型症状和胃角、高位、巨大溃疡多见,出血机率高,需治疗基础病,明确诊断,降低死亡率。

Objective To improve the ability of diagnosis and treatment for peptic ulcer by analyzing the clinical specificity of different age groups. Methods 331 patients were allocated to the aged group（ 129 patients） and the young and middle age group （ 202 patients）. The adverse factors, clinical symptoms, ulcer lesions site, detective result of Helicobacter pylorl, complications and other chronic diseases in the two groups were analyzed comparatively. Results Long-term smoking, drinking, and taking NSAIDS accounted for a high proportion of all cases in the two groups. 35.6% of the elderly were with atypical symptom. The risk of gastric ulcer was higher in the old age group （34.8%） than the young and middle age group（ 17.3% ） ,P 〈 0.01 ;Acute perforation was common in most young patients. Upper gastrointestinal bleeding was one of the main complications in the old patients. More than half of the old patients associated with three or more chronic diseases. Conclusions The characteristics of gastroduodenal ulcer differ with age. The gastric ulcers of aged people occur usually in gastric angle or other high position with atypical symptom, and are often huge ulcers with a high probability of bleeding. The treatment of chronic disease and early diagnosis are important in reducing mortality.