老年人消化性溃疡476例临床分析

目的：分析老年人消化性溃疡的临床特点、溃疡大小与部位、溃疡大小与良恶性的关系以及溃疡部位与良恶性的关系。方法：以我院１９８０年１月至１９９６年１２月间经胃镜和手术证实的４７６例６０岁以上消化性溃疡病人为研究对象。结果：老年消化性溃疡６３．０３％的临床症状无明显规律性及节律性，无症状者占６．９３％，以并发症就诊者占１１．７６％，并发症中以消化道出血多见，占４３． ０７％。老年人胃溃疡的患病率高于十二指肠溃疡。小于２ｃｍ的溃疡， ８５． １４％位于十二指肠球部，大于２ｃｍ的溃疡，４７．０６％位于胃体。恶性溃疡主要发生在胃窦及胃体部，尤其是胃窦部及大于２ｃｍ的大溃疡中。结论：老年人消化性溃疡临床症状不典型，小于２ｃｍ的溃疡以球部为多，大与２ｃｍ的溃疡以胃体多见，恶性溃疡以胃体及胃窦多见，大多数直径大于２ｃｍ。

Clinical study of 476 cases of peptic ulcer in the elderly patients

Objective: To study the clinical characteristics and relationships between size and location of ulcer, size and quality of ulcer, and location and quality of ulcer in elderly patients with peptic ulcer. Methods: 476 elderly patients with peptic ulcer diagnosed by endoscopy and confirmed by surgical operation during January 1980 to December 1996 were investigated. Results: Abdominal pain was irregular in 63. 03 % of the elderly patients. 6 .93 % of patients had no symptoms and 11. 76% first complained of the manifestation of complications, 43. 07 % of which were hemorrhage. The incidence of gastric ulcers in the elderly was more than that of duodenal ulcer. 85. 14% of ulcers less than 2cm were in duodenal bulb, whereas 47. 6% of ulcers more than 2cm were in gastric body. Most of malignant ulcer were in gastric body and gastric antrum and most of them were more than 2cm in sizes. Conclusions: Clinical symptoms in elderly patients with peptic ulcer were often atypical. Most of duodenal ulcers were less than 2cm in diameter, most whereas of ulcers of gastric body were more than 2cm. Malignant ulcers were mainly situated gastric body and gastric antrum and were often more than 2cm in diameter.