老年患者消化性溃疡并出血或穿孔临床分析

目的：通过分析近十余年医院收治的232例老年消化性溃疡并出血或穿孔的临床资料，以加深对本病的认识，提高诊断及治疗水平。方法：采用回顾性研究的方法，对2000年1月-2012年6月收治的符合消化性溃疡并出血或穿孔诊断标准的老年患者进行分析。结果：232例老年消化性溃疡中198例合并出血，34例合并穿孔，212例幽门螺杆菌阳性，73例有服用NSAID类药物史，26例恶性溃疡。结论：老年性消化性溃疡的发病机制是综合，复杂的，出血及穿孔是常见的两个并发症。由于老年人胃黏膜防御因子减弱，动脉硬化，器官组织退行性变，服用NSAID类药物，加之合并有其他疾病如冠心病，高血压等，导致症状不典型，病变愈合慢，易复发，病情严重，复杂。临床医师对老年患者要高度重视，要加深对本病的认识，提高诊断及治疗水平。

The Clinical Analysis on Elderly Patients with Peptic Ulcer Bleeding or Perforation

Objective：To analyze the last ten years of 232 elderly patients admitted to hospital and peptic ulcer bleeding or perforation of the clinical data in order to deepen the understanding of the disease,improve diagnosis and treatment standards. Method：A retrospective study method of elderly patients who were treated by peptic ulcer bleeding or perforation meet diagnostic criteria from January 2000 to June 2012 were analyzed. Result：Two hundred and thirty-two cases of elderly peptic ulcer hemorrhaged in 198 cases,34 cases with perforation,212 cases of H. pylori positive,73 cases had history of NSAID use drugs,26 cases of malignant ulcers. Conclusion：The pathogenesis of senile peptic ulcer is a comprehensive,complex. Bleeding and perforation is common to both complications due to gastric mucosal defensive factors weakened the elderly,atherosclerosis,organ and tissue degeneration,taking NSAID drugs,coupled associated with other diseases such as coronary heart disease,high blood pressure,leading to atypical symptoms,lesions heal slowly,easy to relapse,serious illness,complicated. Clinicians in elderly patients should attach great importance to deep the understanding of the disease,improve diagnosis and treatment standards.