老年消化性溃疡213例临床分析

Clinical analysis of 232 elderly patients with peptic ulcer

目的探讨老年消化性溃疡的临床特点。方法 2008年8月至2013年4月,将在我院消化内科和老年病科住院的年龄≥60岁的老年消化性溃疡患者213例设为试验组,同期住院的年龄<60岁非老年消化性溃疡并出血患者877例设为对照组。观察两组患者临床症状、伴发疾病、溃疡发生部位及大小、Hp检出率。结果试验组典型临床症状出现率为12.2%,对照组为45.0%,差异有统计学意义(χ2=77.9,P<0.01);试验组伴发疾病率为54.5%,对照组20.0%,差异有统计学意义(χ2=93.9,P<0.01);试验组溃疡主要位于胃,对照组溃疡多位于十二指肠球部,差异有统计学意义(χ2=29.1,P<0.01);试验组中溃疡直径≥2 cm者占10.3%,对照组占4.0%,差异有统计学意义(χ2=10.7,P<0.01);试验组Hp感染率为90.1%,对照组Hp感染率为86.1%,差异无统计学意义(χ2=3.12,P>0.05)。结论老年性消化性溃疡患者典型临床症状少,伴发疾病多,以胃溃疡为主,溃疡直径大,需要引起临床重视。

Objective To evaluate the clinical characteristics of elderly patients with peptic ulcer. Methods Pa- tients of peptic ulcer in the Department of Geriatrics and Gastroenterology from August 2008 to April 2013 were divided into two groups, 213 of which no younger than 60 years old were enrolled as the experimental group, and 877 younger than 60 years old were set as the control group. The clinical symptoms, concomitant diseases, ulcer location, ulcer size and Hp detection rate were observed. Results The incidence of typical symptoms was 12.2% in the experimental group and 45.0% in the control group, with statistically significant difference between the two groups （Lr~=77.9, P〈0.01）. The in- cidence of concomitant diseases was 54.5% in the experimental group and 20.0% in the control group, with statistically significant difference between the two groups （Zz--93.9, P〈0.01）. The ulcers were mainly located in stomach in the exper- imental group and duodenal ulcer in the control group, and the difference was statistically significant （gz-=-29.1, P〈0.01）. The ratio of ulcers ~〉2 cm in diameter was 10.3% in the experimental group and 4.0% in the control group, with sta- tistically significant difference between the two groups （Z2=10.7, P〈0.01）. The Hp infection rate was 90.1% in the ex- perimental group, 86.1% in the control group, but the difference was not statistically significant （x2=-3.12, P〉0.05）. Condusion Elderly patients with peptic ulcer have characteristics of fewer typical clinical symptoms, more concomi- tant diseases, more gastric ulcer and larger ulcer diameter, which need to be paid more attention in clinical work.