老年消化性溃疡的临床特点

为了解老年消化性溃疡的临床特点 ,总结其诊断及治疗的经验 ,观察我院 2 0 0 1— 2 0 0 2年 63例老年住院消化性溃疡病人的溃疡部位、大小、合并症的发生率和预后情况。结果 :63例老年消化性溃疡患者中巨大消化性溃疡的发生率高达 2 7.0 % ( 1 7/63 ) ,以出血 (呕血、黑便 )为首发症状者最多 ,为 46例 ( 73 .0 % ) ,晕厥者占 1 7.5 % ( 1 1 /63 ) ,溃疡穿孔占 1 7.5 % ( 1 1 /63 ) ,规律性上腹痛很少。提示 :老年人消化性溃疡因临床症状不典型、病史长而易被忽视 ,因多合并全身性疾病而增加病死率 ,内镜下明确诊断和及时止血治疗为首选治疗 ,掌握手术时机对预后有重要影响 ;抗幽门螺杆菌 (HP)治疗可明显减少溃疡复发。

Clinical Observation of Peptic Ul cer in the Aged

To identify the characteristics of peptic ulcer in the aged in relation to diagnosis and treatment. Analysis was made regarding location of ulcer and frequency of complications in 63 cases of peptic ulcer in the aged hospitalized between 2001-2002. Results: Large area peptic ulcer in aged peptic ulcer is as high as 27.0% of total cases reported, Among the complications, bleeding was the initial symptom, there are 17.5% syncope cases and 17.5% peptic perforation, regular upper abdominal pain is rare. In peptic ulcer among aged persons, the symptom is atypical, so diagnosis is easy to be delayed with many other illness as complications, which increases mortality. Gastroendoscopic diagnosis in time and treatment for bleeding are crucial. Operation in appropriate time also affects the prognosis. Anti-HP treatment prominently decreases recurrence of peptic ulcer.