上海市嘉定地区2870例消化道溃疡内镜下改变临床分析

A clinical study of 2870 cases of peptic ulcer of endoscopy diagnosis in Jiading distract of Shanghai

目的探讨消化性溃疡的分布规律,以内镜下改变及病理学分析为节点,揭示溃疡的特点,更好地指导今后的临床及科研工作。方法收集2 870例胃镜检查人群的基本信息,包括性别、年龄、胃镜检查结果及相关病理结果。行胃溃疡、十二指肠球部溃疡、复合性溃疡分组并对收集资料进行分析。结果经胃镜检查确诊为消化性溃疡,总检出率为13.62%,男女之比约为2.6∶1,年龄(49.41±15.26)岁,3~6月份检出率显著高于其他季度,3年消化性溃疡的年检出率差异无统计学意义,消化性溃疡直径<1 cm占74.15%,幽门螺杆菌(Helicobacter pylori,H.pylori)阳性占71.64%。十二指肠球部溃疡、胃溃疡、复合性溃疡、食管溃疡检出率占消化性溃疡的48.19%、46.48%、4.18%、1.15%。十二指肠溃疡与胃溃疡之比约为1.04∶1。溃疡部位以十二指肠球部前壁溃疡、胃窦部前壁溃疡、十二指肠球部溃疡+胃窦者、食管下段最多见,恶性溃疡占胃溃疡、复合性溃疡、食管溃疡的8.92%、2.50%、27.27%。十二指肠溃疡、胃溃疡、复合性溃疡、食管溃疡H.pylori感染率分别为74.84%、66.94%、86.67%、72.73%。结论根据上海市嘉定地区消化性溃疡病的检出率分析有必要在50岁以上人群中全面开展胃镜工作,全面提高消化性溃疡诊疗水平,检测H.pylori感染等。全面了解上海消化性溃疡的发病规律,为如何降低本市人群中消化性溃疡疾病的发病率提供依据。

Objective To evaluate the distribution and characteristics of peptic ulcer by endoscopic and pathological changes in order to further guide of clinical and basic study. Methods The data of 2 870 cases of people including gender, age, the result of endoscopy examination and pathology were collected and the differences and similarities were explored by statistic analysis in different groups of the information including gastric ulcer, duodenal bulbar ulcer, compound ulcer and esophageal ulcers. Results The detection rate of peptic ulcer for 13.62% were diagnosed by endoscopy, which was higher in 3 - 6 months than that other quarter of a year, the ratio of male to female patients was 2.6： 1. The average age was （49.41±15.26） years old. The ratio of ulcer diameter less than 1 cm was 74.15%. Helicobacter pylori （H. pylori） positive rate was 71.64%. There was no difference in the detection rate during 3 years. The detection rate of duodenal bulbar ulcer, gastric ulcer, compound ulcer and esophageal ulcers were 48. 19% , 46.48% , 4.18% , 1.15% , respectively. The ratio of duodenal bulbar ulcer to gastric ulcer was 1.04： 1. The site of ulcer was most common in the front wall of duodenal bulb, the front wall of gastric antrum, the duodenal add gastric antrum, the lower part of esophagus. The ratios of malignant ulcer were 8.92% , 2.50% , 27.27% in gastric ulcer, compound ulcer, and esophageal ulcer, respectively. H. pylori positive rate of duodenal bulbar ulcer, gastric ulcer, compound ulcer and esophageal ulcers were 74. 84% , 66.94% , 86.67% , 72.73% , respectively. Conclusion In Jiading district, the detection rate of peptic ulcer is still high, it is necessary to carry out endoscopy in 50 years old people, improve the levels of diagnosis of peptic ulcer, investigate of H. pylori infection, and so on, which provide measures to reduce the incidence of peptic ulcer in the city.