121例老年消化性溃疡临床及胃镜特点分析

Analysis of Clinical and Gastroscopic Characteristics in 121 Elderly Patients with Peptic Ulcer

目的探讨老年消化性溃疡的临床及胃镜特点。方法回顾性分析我院消化内镜室2009年1月至2011年8月经胃镜检出的老年消化性溃疡患者，并与近期行胃镜检查的60岁以下的中青年消化性溃疡患者进行对比。结果老年组典型腹痛发生率为54．5％，青中年组腹痛发生率为76．1％：两组相比胃及十二指肠溃疡差异具有统计学意义（P〈0．05），老年组胃体溃疡占胃溃疡的37．5％，直径〈1cm的溃疡占38．0％，直径〉2cm的溃疡占347％：中年组胃体溃疡占胃溃疡的23．5％，直径〈1cm的溃疡占67．6％，直径〉2cm的溃疡占7．0％，两组比较有统计学意义（P〈0．05）。老年组发生梗阻和癌变率更高。结论消化性溃疡老年患者较青年患者临床症状更不典型，溃疡面积较大，发生在胃体较多，梗阻和癌变并发症更多。

Objective To investigate the clinical and gastroscopic characteristics of elderly patients with peptic ulcer. Methods Elderly patients with peptic ulcer confirmed by gastroscopy in our gastroenterological endoscope center from January 2009 to August 2011 were retrospectively analyzed and compared with those of 〈 60 years old with peptic ulcer detected recently. Results There were 121 peptic ulcer cases including 56 cases of gastric ulcer,54 cases of duodenal ulcer, 11 cases of complex ulcer in the aged group and 142 peptic ulcer cases of 〈 60 years oht including 51 cases of gastric ulcer,77 cases of duodenal ulcer, and 14 cases of complex ulcer. Significant statistical difference of gastric ulcer was detected between the two groups （P〈 0.05 ）. For the elderly group with gastric ulcer, gastric body ulcer was the dominant（37.5%）,and 34.7% were 〉2 cm in diameter. It＇s 23.5% and 7.0% ,respectly,in 〈 60 years old group. Obstruction and canceration were more commom in the aged group. Conclusion For the elderly peptic ulcer, clinical symptoms are un-typical, gastric ulcer is common, ulcers are larger and often located in gastric body and more and severe complications are seen.