【摘要】 目的探讨老年患者消化性溃疡的临床与胃镜特点,为诊断和治疗提供依据。方法回顾性分析2011年1月—2016年12月住院治疗的老年消化性溃疡患者187例和非老年消化性溃疡患者239例,对比分析其临床表现与内镜特点。结果老年患者消化性溃疡临床症状不典型,以呕血/黑便为首发症状,而非老年组患者则为典型节律性疼痛;老年患者发病诱因主要是饮酒和服用非甾体类抗炎药,与非老年组比较,差异均有统计学意义(P<0.001);老年患者以胃溃疡多见,非老年患者以十二指肠球部溃疡多见,二者比较差异有统计学意义(P<0.001);老年患者胃溃疡和十二指肠球部溃疡直径大于2 cm的溃疡较非老年患者明显增高,二者比较差异有统计学意义(P<0.001)。结论老年患者消化性溃疡临床症状多不典型,其病变部位、病变大小和常见发病诱因与非老年患者均存在显著差异,对老年患者消化性溃疡需要进行针对性诊断与治疗。更多还原

【Abstract】 Objective To investigate the clinical and gastroscopic features of peptic ulcer in the elderly,and to provide a basis for relevant diagnosis and treatment. Methods A total of 187 elderly cases with peptic ulcer and 239 control cases from January 2011 to December 2016 were enrolled in this study. Their clinical manifestations and gastroscopic results were analyzed. Results The clinical symptoms of the elderly cases with peptic ulcer were not typical, showing first signs of haematemesis and melena,while the controls showed typical symptoms. Drinking and taking nonsteroids antiinflammatory drugs( NSAIDs) were the risk factors for peptic ulcer of the elderly patients,and there were significant differences in the rates of drinking and taking NSAIDs between the two groups( P < 0. 001). The elderly patients reported more gastic ulcers, the controls reported more duodenal ulcers, and there were significant differences in the incidence rates of the two diseases( P < 0. 001). A higher rate of large ulcers( diameter > 2 cm) was found in the elderly patients than in the controls, and the difference was significant( P < 0. 001). Conclusion The clinical symptoms of peptic ulcer are not typical in the elderly patients. There are significant differences between the elderly patients and controls in lesion site, lesion size, and risk factors. Targeted diagnosis and treatment of peptic ulcer are required for the elderly.更多还原