不同年龄消化性溃疡263例临床分析(1)
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【摘要】 目的比较不同年龄消化性溃疡患者的临床特点。方法 共263例消化性溃疡患者,对不同年龄组的主要症状、溃疡发生的部位、与NSAIDs相关性、伴随的慢性疾病以及治疗和转归等进行比较。结果 老年组有典型症状者显著少于中青年组;老年组和中青年组胃溃疡分别占47.6%和26.9%(P=0.001);两组胃多发溃疡分别占13.1%和5.1%(P=0.022);溃疡直径≥2 cm者分别占17.8%和9.0%(P=0.012);恶性胃溃疡分别占22.4%和1.9%(P<0.001);伴存病分别占75.7%和18.6%(P<0.001),与NSAIDs相关的溃疡老年组与中青年组分别为35.5%和10.3%(P<0.001)。结论 老年人消化性溃疡患者症状不典型,胃溃疡、胃多发溃疡、巨大溃疡和恶性胃溃疡构成比高,老年人伴存疾病多。
【关键词】 消化性溃疡;临床分析;老年人
263 Cases of Digestive Ulcer at Different Ages: a Clinic Analysis
HUN Jun,SUN Xiao-bin.People’s Hospital of Pi country, SiChuan 611730,China
【Abstract】 Objectiveto compare clinic features of digestive ulcer patients at different ages. MethodsComparisons were made in 263 patients of digestive ulcer divided into different age groups in terms of main symptoms, ulcer locations, correlation with NSAIDs, concomitant chronic diseases, treatments and prognosis. Resultsthe old-aged group showed significantly less typical symptoms than the young group; gastric ulcer accounts for 47.6% and 26.9% respectively in old-aged group and young group(P=0.001); gastric multiple ulcer accounts for 13.1% and 5.1% respectively(P=0.022);the diameter≥2 cm accounts for 17.8% and 9.0% respectively m alignant gastric ulcer accounts for 22.4% and 1.9%(P<0.001);concomitant diseases 75.7% and 18.6%(P<0.001); NSAIDs-related ulcer 35.5% and10.3%(P<0.001).ConclusionOld patients with digestive ulcer have less typical symptoms, higher proportion of gastric ulcer, gastric multiple ulcer, ulcer of large size as well as m alignant gastric ulcer,and more concomitant diseases.
【Key words】Digestive ulcer; clinic analysis; old patients
消化性溃疡是常见、多发病,临床表现常不典型,并发症多且严重。本文就我院近年收治的消化性溃疡患者进行分析,并对老年人和中青年人消化性溃疡的临床特点进行比较。
1 资料与方法
1.1 一般资料 收集2003年1月至2008年2月在我院住院和门诊的消化性溃疡患者263例,男性191例,女性72例,男女比2.65:1,平均年龄51岁(15~86岁)。按≥60和<60岁分为老年组和中青年组,老年组107例,平均70岁(60~86岁),中青年组156例,平均37岁(15~59岁)。
1.2 诊断 251例为胃镜诊断(FUJINON EVEW-88A),12例因穿孔行手术诊断,所有胃溃疡患者均行组织活检,活检为良性并未行手术治疗的胃溃疡患者随访1年排除胃癌。全部患者均询问服用非甾体类抗炎药(NSAIDs)史,241例取胃窦黏膜组织1块行快速尿素酶试验。既往有胃癌病史、应激性溃疡、吻合口溃疡、肝硬化食道胃底静脉曲张破裂出血及血液疾病所致出血的病例除外。
1.3 统计学处理 采用SPSS 13.0软件包进行统计分析,计数资料的比较用χ2检验,如有必要,采用Yates校正χ2检验或Fisher’s精确概率法检验 ......
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