老年人消化性溃疡并大出血临床及病理特征分析

目的探讨老年人消化性溃疡出血的临床及病理特征。方法 116例消化性溃疡患者,根据年龄将患者分为老年组(≥60岁)和中青年组(<60岁),比较两组的消化性溃疡出血的临床及病理特征。结果老年组典型上腹痛、无症状、伴随发病率依次为11.8%、35.3%、30.9%;中青年组依次为43.8%、31.3%3、5.4%(P<0.05);老年组胃溃疡、十二指肠溃疡、巨大溃疡(直径>2 cm)发生率依次为52.9%、19.1%、20.6%;中青年组依次为10.4%、60.4%、8.4%(P<0.05)。老年组出血量1 000 mL以上分别为22.1%,中青年组为8.3%(P<0.05)。结论老年组典型上腹痛少、无症状伴随疾病多,胃溃疡及十二指肠溃疡多、异型增生多,大出血、中重度贫血多见,临床治疗难度大。

Clinical and pathologic features of elderly patients with peptic ulcer complicated with massive hemorrhage

Objective To explore the clinical and pathological features of peptic ulcer with hemorrhage in elderly patients.Methods 116 patients with peptic ulcer were divided into elderly group(≥ 60 years) and middle-aged group(<60 years old);we compared the clinical and pathological features of the two groups.Results In the elderly group,the incidence of epigastric pain,asymptomatic and accompanying disease were 11.8%,35.3% and 30.9%,respectively;the middle-aged group were 43.8%,31.3% and 35.4%, respectively(P<0.05).In the elderly group,the incidence of gastric ulcer, duodenal ulcer and giant ulcers(diameter> 2 cm) were 52.9%,19.1% and 20.6%,respectively;the middle-aged group were 10.4%,60.4% and 8.4%,respectively(P<0.05).In the elderly group,loss more than 1000 ml blood was 22.1%;the middle-aged group was 8.3%(P<0.05).Conclusions Elderly patients of peptic ulcer with less epigastric pain,more asymptomatic disease,gastric ulcer,duodenal ulcer,dysplasia,and bleeding,severe anemia are are difficult to cure.