139例老年消化性溃疡临床与胃镜特点分析

Analysis of Clinical and Gastroscopic Characteristics in 139 Elderly Patients with Peptic Ulcer

目的:探讨老年消化性溃疡的临床与胃镜特点。方法:回顾性分析我院消化内镜中心2007年1月至2009年1月经胃镜检出的老年消化性溃疡患者,并与同期行胃镜检查的60岁以下的中青年消化性溃疡患者进行对比。结果:老年组139例,胃溃疡68例,十二指肠球部溃疡57例,复合溃疡14例;中青年组110例,胃溃疡32例,十二指肠球部溃疡70例,复合溃疡8例。两组相比胃溃疡差异具有统计学意义(P<0.01)。老年组胃体溃疡占胃溃疡的36.8%,直径>2cm的溃疡占29.4%,并发症以上消化道出血为主,占43.9%,差异均较中青年组有统计学意义(P<0.05,P<0.05,P<0.01)。结论:老年消化性溃疡临床症状不典型,伴随疾病多,溃疡部位由幽门向贲门推移,溃疡面积较大,并发症多且较严重。

Objective：To investigate the clinical and gastroscopic characteristics of elderly patients with peptic ulcer. Methods： Elderly patients with senile peptic ulcer confirmed by gastroscopy in our gastroenterological endoscope center from Jan 2007 to Jan 2009 were retrospectively analyzed and compared with those of 60 years old with peptic ulcer detected contemporarily. Results： There were 139 peptic ulcer cases, including 68 cases of gastric ulcer, 57 cases of duodenal ulcer, 14 cases of complex ulcer in the aged group, and 110 peptic ulcer cases of 60 years old, including 32 cases of gastric ulcer, 70 cases of duodenal ulcer, and 8 cases of complex ulcer. Significant statistical difference of gastric ulcer was detected between the two groups （P0.01）. For the elderly group with gastric ulcer, gastric body ulcer was the dominant （36.8%）, and 29.4% were 2 cm in diameter. Upper gastrointestinal hemorrhage was the most common complication, accounting for 43.9%. Conclusion： Clinical symptoms of elderly peptic ulcer are typical, comorbiditis are common, ulcers are larger and often located near cardia instead of pylorus, and more and severe complications are seen.