成都区域性老年性消化性溃疡内镜特点

目的 根据我院老年性消化性溃疡的检出情况及内镜下特征，探讨老年性消化性溃疡的特点。方法总结我院2004．8—2008．7间经胃镜确诊的4554例消化性溃疡患者，比较老年组和中青年组消化性溃疡的检出率、大小、部位、并发症、Hp阳性率及老年性胃溃疡与溃疡型胃癌的发生部位和大小。结果 老年组和中青年组消化性溃疡的检出率分别为5．98％和4．86％（P〈0．01），且胃溃疡、十二指肠溃疡和复合性溃疡在两组的检出率均有差别（P〈0．01）；两组胃溃疡的发生部位没有差别（P〉0．05），平均溃疡面积分别为1．479±3．737和3．209士7．914（P=0．015）；两组并发症的发生率分别为2．3％和0．89％（P〈0．005），不同类型溃疡的Hp的检出率差异无统计学意义。老年性溃疡型胃癌在胃底的发生率高于胃溃疡（P=0．0005），面积大于胃溃疡（P〈0．005）。结论老年性消化性溃疡的发病随年龄的增加而增加，胃溃疡多好发于胃窦和胃角，并发症发生率高。溃疡性胃癌则好发于胃底，且溃疡的面积大。

Endoscopic Features of Senile Peptic Ulcer in Chengdu Region

Objective To study features of senile peptic ulcer based on the detection rate and endoscopic features of peptic ulcer in elderly patients in our hospital. Methods Peptic ulcer was confirmed by gastroscopy in 4,554 patients between August 2004 and July 2008, whose detection rate, size, location, complication, and the Hp positive rate of peptic ulcer between the old age group and the young group were compared. Results The detection rate of peptic ulcer was 5.98 % in the old age group and 4.86% in the young group （P 〈0.01）. There was a significant difference in the detection rate of gastric ulcer, duodenal ulcer and composite ulcer between the two groups （P 〈0.01）, while there was no significant dif- ference in the location of gastric ulcer （P〉 0.05）. The mean ulcer area was 1.479 ＋ 3.737 in the old age group and 3.209 ＋ 7.914 in the young group （P = 0.015）. The incidence of complications in the old and young age groups was 2.3 % and 0.89% respectively （P 〈0.005）. There was no significant difference in the positive rate of Hp between the two groups. Senile ulcerative gastric cancer had a higher incidence than gastric ulcer in the gastric fundus （P = 0.0005）, and a bigger ulcer area than gastric ulcer （P 〈 0.005）. Conclusions The incidence of senile peptic ulcer increases with age. Gastric ulcer is more likely to occur in the gastric antrum and angle with a higher incidence of complications, while ulcerative gastric cancer is more likely to occur in the gastric fundus with a bigger ulcer area.