中青年人胃溃疡132例临床分析

A Clinical Analysis of 132 Young Patients with Gastric Ulcer

目的探讨中青年人胃溃疡的临床及病理特点。方法对132例中青年人胃溃疡患者临床、病理资料进行系统性回顾,并与118例老年患者作对比分析。结果病因分析:中青年组不合理饮食、不规律睡眠方面多见,幽门螺杆菌(Hp)感染者和长期服用非甾体消炎药方面老年组多见,长期吸烟两组比例相似。临床表现:中青年组有典型上腹痛、反酸、嗳气、压痛者占大多数,两组上腹饱胀表现比例相似,非典型上腹痛、食欲减退、无症状表现老年组多于中青年组。好发部位:中青年组胃窦溃疡多于老年组,老年组胃底、胃体溃疡多于中青年组,胃角、幽门管溃疡两组比例相似。溃疡形态与大小:中青年组溃疡均深而较小,溃疡大小<2.5 cm者居多,老年组浅而较大,胃溃疡大小≥2.5 cm者居多。病理组织学改变:中青年组轻-中度粘膜萎缩、肠上皮化生、LGIN、重度粘膜萎缩均少于老年组。并发症:中青年组发生率28.00%,老年组并发症发生率44.04%,中青年组低于老年组。伴随其他疾病:中青年组伴随疾病发生率61.34%,老年组伴随疾病103.35%,中青年组低于老年组。结论中青年人胃溃疡主要病因可能是Hp感染和长期吸烟,但不合理饮食、不规律睡眠方面也多见,大多数有上腹痛,好发于远端胃,溃疡较小而深,恶变者很少见,并发症少见,伴随疾病发生率低。

Objective To investigate the clinical and pathological characteristics of gastric ulcer in youth. Methods The clinical and pathological features of 132 young patients with gastric ulcer were analyzed retrospectively and com- pared with those of 118 aged patients respectively. Results Cause analysis： sleep in the young group, irrational diet, not rules. Helicobacter pylori （Hp） infection and the long - term use of non steroidal anti - inflammatory drugs in aged group rare, long - term smoking two groups of similar proportions. Clinical manifestation ： in the young group has the typ- ical upper abdominal pain, acid regurgitation, belching, accounted for most of the two groups of tenderness, abdominal distension show similar proportions, atypical upper abdominal pain, anorexia, no symptoms of elderly group more than the young group. Good hair place： in the young group, gastric ulcer than in aged group, aged group of gastric fundus, gastric body ulcer than in the young group, gastric angle ulcer of pyloric canal, two groups of similar proportions. Ulcer morphology and size： in the young group were deep and small ulcer, ulcer size 〈2. 5 cm are shallow and large, old group, gastric ulcer size was larger than 2. 5 cm. Histopathological changes ： in the young group, mild to moderate muco- sal atrophy, intestinal metaplasia, LGIN, severe mucosal atrophy was less than the elderly group. Complications： in the young group, the incidence of 28.00% , aged gastric ulcer complication rate was 44.04% , in the young group is lower than that of old group. Along with other diseases ： in the young group, gastric ulcer and concomitant disease incidence was 61.34%, the elderly group with 103.35%, In the young group lower than that of the aged group. Conclusions The main cause of gastric ulcer in young people is the Hp infection and long - term smoking, but sleep is not reasonable diet, not the law also see more, most upper abdominal pain, good hair at the distal stomach ulcer, small and deep, malignan- cy is rare, complications are uncommon.