老年消化性溃疡56例临床分析

目的探讨老年消化性溃疡的临床特点,以提高认识,降低误诊率,提高疗效。方法 231例患者均经电子胃镜诊断为消化性溃疡,按年龄分为两组,其中老年组(≥60岁)56例,中青年组(<60岁)175例。比较两组的发病原因、临床表现、溃疡部位及并发症。结果老年组患者反酸嗳气、食欲下降、呕血、黑便发生率为32.1%,低于中青年组的52.0%,差异有统计学意义(P<0.05);老年消化性溃疡好发于胃体部,占42.72%,其他部位依次为胃窦、胃角、胃底及幽门管;中青年对照组溃疡好发于胃窦,占41.22%,其次为胃角,两组患者溃疡好发部位比较,差异有统计学意义(P<0.05)。结论临床上应加强对老年消化性溃疡的认识,以降低误诊率,提高临床疗效。

Clinical analysis of 56 cases with senile peptic ulcer

Objective The study is aimed to analyze characteristic features of peptic ulcer disease in the elderly. Methods 231 patients with peptic ulcers confirmed by electronic endoscopy were recruited for the study and divided into elderly （〉60 years, n=56） and young or middle-aged （〈60 years, n= 175） groups. The etiologies, clinical features, locations and complications of ulcers were compared between two groups. Results Elderly patients with peptic ulcer presented with diversified clinical manifestations. Acid dyspepsia, loss of appetite, hematemesis and melena were more common （P〈0. 05） and abdominal pain was less common in the elderly patients than in young and middle- aged patients. Although the most common site of peptic ulcers in elderly group was body of stomach （42. 72 %）, ulcers also occurred in antrum, angulus, fundus and pylorus. In young and middle- aged group, ulcers were mainly found in antrum （41.22%） and angulus. Conclusion Elderly patients with peptic ulcers may present with nonspecific complaints and more likely have painless ulcer and hemorrhagic complications. It is important to be aware of these characteristics for the diagnosis of senile peptic ulcer.