老年患者消化性溃疡复发相关因素临床分析

Clinical Analysis of Factors Related to Peptic Ulcer Recurrence in Elderly Patients

目的探讨并分析老年消化性溃疡患者复发的危险因素,为临床治疗复发性老年消化性溃疡提供参考。方法以我科室2016年4月至2017年4月间收治的160例老年消化性溃疡病例作为研究对象,按复发情况分为复发组57例,未复发对照组103例。统计患者病理学资料、溃疡特点、治疗情况、生活习惯、精神状态等消化性溃疡复发常见危险因素,分析其对老年患者消化性溃疡复发的影响。结果在所研究患者中,复发人数占总数的35.6%。复发组患者中胃溃疡、十二指肠溃疡比例略低于对照组,差异无统计学意义(P>0.05);复合溃疡比例显著高于对照组,差异有统计学意义(P<0.05)。复发组患者中,幽门螺杆菌(HP)感染阳性率显著高于对照组,差异有统计学意义(P<0.05);溃疡内径大于2cm以及合并高血压与复发显著相关,服用非甾体药物(NSAIDs)、未维持治疗、吸烟饮酒嗜好是复发的显著相关因素。结论老年患者消化性溃疡出现复发现象几率较高,复发因素多样,临床治疗时应针对性合理用药,从多种途径治疗和预防复发。

Objective To explore and analyze the recurrence risk factors of peptic ulcer in elderly patients,and to provide reference for clinical treatment of recurrent peptic ulcer in the elder. Methods 160 elderly patients with peptic ulcer received in our department from April 2016 to April 2017,were divided into recurrent group（ 57 cases） and control group（ 103 cases）. The common recurrence risk factors of peptic ulcer,such as pathological data,ulcer characteristics,life habits and mental states of the patients,were collected and their influence on the recurrence of peptic ulcer in elderly patients was analyzed.Results Among the total,the relapsing patients covered 35. 6%. The proportion of gastric ulcer and duodenal ulcer in recurrent group was lower than that in control group,the difference with no statistically significant（ P〈0. 05）. The proportion of complex ulcer in recurrent group was significantly higher than that in control group,the difference being statistically significant（ P〈0. 05）.The positive rate of Helicobacter pylori（ Hp） infection in recurrent group was significantly higher than that in control group,the difference being statistically significant（ P〈0. 05）.Recurrence was significantly related to an inner ulcer diameter bigger than 2 cm and a complication of hypertension,other correlative factors including medication of NSAIDs,therapy discontinued,smoking and alcohol intake. Conclusion The recurrence rate of peptic ulcer in elderly patients was high,resulting from multiple factors,which needs pertinent medication,treatment and preventive measures through different approaches.