三种药物联合应用治疗消化性溃疡80例

目的观察药物联合应用治疗消化性溃疡疗效．方法消化性溃疡80例，应用吗丁啉10mg，雷尼替丁150mg，阿莫西林500mg，3次／d进行治疗．其中胃溃疡27例（33．75％）、十二指肠球部溃疡51倒（63．75％）、复合性溃疡2例（2．5％）．男66例，女14例，年龄21岁～48岁，其中31岁～48岁者49例（61．2％），病程1a～9a（平均2．5a）．4wk为1疗程结束后，对患者的临床症状及疗效进行分析．结果经药物联合应用治疗4wk后，临床症状痊愈32例，显效28例，好转17例，无效3例，总有效率为96．25％，引起溃疡阳性率例数为：胃溃疡27例，十二指肠球部溃疡51例，复合溃疡2例，治疗后（除3例无效外）随访1a未复发．结论联合用药治疗消化性溃疡有良好的治疗作用。     

内镜下微波治疗消化性溃疡疗效观察

１９９２年１２月至１９９６年４月 ,我院应用内镜微波技术治疗消化性溃疡１２８例，对照组用雷尼替丁治疗消化性溃疡６２例，现将其结果报告如下 :１．临床资料 :治疗组１２８例，其中男８６例，女４２例，年龄为１６～８２岁，平均年龄３７．４岁，胃溃疡３８例，十二指肠球部溃疡８２例，复合性溃疡８例。溃疡直径≤１．０ｃｍ８４例（６５．５ %），１．１～２．０ｃｍ３９例（３０．４ %），２．１ｃｍ以上５例（４．０ %）。对照组６２例，其中男４１例，女２１例，年龄为１９～７４岁，平均年龄３４．９岁，胃溃疡１６例，十二指肠球…     

高原地区上消化道疾病胃镜分析13944例

目的:探讨青藏高原地区胃镜下上消化道疾病的发病特点.方法:对我院11年间经胃镜检查13944例患者的临床资料及相关信息进行回顾性分析,包括年龄构成、疾病检出情况、常见疾病如消化性溃疡的临床特点等.结果:13944例患者中男女之比为1.7∶1;行胃镜检查人群年龄20-50岁者占总人数的81.3%,其中31-40岁占总人数的32.47%;通过逐年逐月统计,上消化道疾病每年检出率无明显增多或减少,多以夏秋季好发;其发病依次为浅表性胃炎、十二指肠溃疡、平坦糜烂性胃炎、出血性胃炎、反流性食管炎、十二指肠炎、隆起糜烂性胃炎、胃溃疡、上消化道息肉、上消化道肿瘤等;以男性多见于女性(P<0.05);炎性疾病、消化性溃疡31-40岁为疾病高峰年龄,萎缩性胃炎、上消化道息肉、上消化道肿瘤多见于50岁以上人群;十二指肠溃疡与胃溃疡发病率之比为2.86∶1,十二指肠溃疡好发部位为球前壁和大弯侧,胃溃疡好发部位为胃角和胃窦;胃癌最常见于胃窦.结论:高原地区上消化道疾病以男性发病率高,20-50岁为好发人群,炎症性疾病最多,其次为消化性溃疡;由于高原的特殊环境,上消化道疾病每年检出率无明显变化.     

益气活血方治疗老年消化性溃疡106例临床观察

根据老年消化性溃疡的发病特点及临床表现，我们以益气活血、祛腐护膜论治，取得了较好的疗效，现报告如下：1临床资料自1992年3月～1997年8月，经Χ线上消化道造影或胃镜检查确诊为消化性溃疡，年龄在60岁以上共161例，随机分为治疗组106例，对照组55例。其中治疗组男80例，女26例；胃溃疡46例，球溃疡54例，复合溃疡6例；年龄60岁～82岁，平均66岁；病程18天～32年；对照组：男39例，女16例；胃溃疡24例，球溃疡29例，复合溃疡2例；年龄60岁～67岁；病程1天～34年。Z治疗方法治疗组服用自制益气活血方：黄芪30g，党参15g，白芍30g,丹参30…     

120例初发消化性溃疡的治疗

我们对 8 4例初发消化性溃疡患者使用雷尼替丁 阿莫西林 克拉霉素联合治疗 ,并与 36例初发消化性溃疡使用洛赛克 阿莫西林 克拉霉素联合治疗进行对照 ,现将结果报告如下。资料和方法　　一、病例选择　所选 12 0例初发消化性溃疡患者均经我院胃镜证实。对反复发作 ,合并并发症及直径 >2ｃｍ、深度 >1ｃｍ的溃疡予以剔除。用快速尿素酶法检测Ｈｐ为阳性 ,随机分为两组 ,治疗组 (Ａ组 ) 84例 ,男 5 8例 ,女 2 6例 ,年龄 19～ 6 8岁 ,平均 43 12岁 ,其中胃溃疡 (ＧＵ) 18例 ,十二指肠球溃疡 (ＤＵ) 5 7例 ,复合溃疡 (ＣＵ) 9例 ;对照组 (Ｂ…     

老年人消化性溃疡的外科治疗特点

为探讨老年人消化性溃疡的外科治疗特点 ,本文回顾了我科 1 985年以来收治的 3 6例 6 0岁以上老年人消化性溃疡的临床资料 ,现报告如下。1　临床资料本组男 3 0例 ,女 6例 ;年龄 6 0～ 80岁 ,平均6 9.5岁 ,均行手术治疗。其中胃溃疡 2 4例 (包括多发溃疡 6例 ) ,十二指肠溃疡 8例 ,复合性溃疡 4例。本组手术适应症为急性胃溃疡穿孔 1 2例 ,急性十二指肠溃疡穿孔 4例 ,溃疡出血 6例 ,溃疡致梗阻 8例 ,胃溃疡恶变 4例 ,其他 6例。手术方法为胃大部切除术毕 -罗 式 1 1例、 式 9例 ,迷走神经干切断加半胃切除 1例 ,穿孔修补术 1 5例。2　讨论…     

上海市嘉定地区2870例消化道溃疡内镜下改变临床分析

目的探讨消化性溃疡的分布规律,以内镜下改变及病理学分析为节点,揭示溃疡的特点,更好地指导今后的临床及科研工作。方法收集2 870例胃镜检查人群的基本信息,包括性别、年龄、胃镜检查结果及相关病理结果。行胃溃疡、十二指肠球部溃疡、复合性溃疡分组并对收集资料进行分析。结果经胃镜检查确诊为消化性溃疡,总检出率为13.62%,男女之比约为2.6∶1,年龄(49.41±15.26)岁,3~6月份检出率显著高于其他季度,3年消化性溃疡的年检出率差异无统计学意义,消化性溃疡直径1 cm占74.15%,幽门螺杆菌(Helicobacter pylori,H.pylori)阳性占71.64%。十二指肠球部溃疡、胃溃疡、复合性溃疡、食管溃疡检出率占消化性溃疡的48.19%、46.48%、4.18%、1.15%。十二指肠溃疡与胃溃疡之比约为1.04∶1。溃疡部位以十二指肠球部前壁溃疡、胃窦部前壁溃疡、十二指肠球部溃疡+胃窦者、食管下段最多见,恶性溃疡占胃溃疡、复合性溃疡、食管溃疡的8.92%、2.50%、27.27%。十二指肠溃疡、胃溃疡、复合性溃疡、食管溃疡H.pylori感染率分别为74.84%、66.94%、86.67%、72.73%。结论根据上海市嘉定地区消化性溃疡病的检出率分析有必要在50岁以上人群中全面开展胃镜工作,全面提高消化性溃疡诊疗水平,检测H.pylori感染等。全面了解上海消化性溃疡的发病规律,为如何降低本市人群中消化性溃疡疾病的发病率提供依据。     

渔民消化性溃疡335例内镜分析

本文回顾我院8a来经内镜检出的渔民消化性溃疡（PU）进行分析，旨在探讨该病在沿海地区发病因素及其特点．1对象和方法1．1对象全部病例均为1990－01／1998－01我院门诊和住院患者，共335例，其中男293例，女42例1．2方法采用GIFQ20GIFp10EG2940等型号内镜检查，受检者均有不同程度的消化不良，上腹痛，其次是腹胀、反酸、嗳气、黑便及呕血等，内镜诊断标准：十二指肠（DU）以见到溃疡面或霜斑样溃疡，重度幽门狭窄及球腔变形，未见活动性溃疡者不列入本组，部分胃溃疡（GU）和溃疡恶变为病理证实，复合性溃疡（CU）另行统计2结果2．…     

老年人胃十二指肠溃疡穿孔诊治

1988／1994收治50例60岁以上老年溃疡穿孔患者的诊治体会报道如下：1临床资料1．1一般状况50例中，男36例，女14例，最大年龄88岁，平均68．4岁．其中60岁～70岁之间23例（46％），70岁～80岁之间对例（42％），80岁以上6例（12％）1．2穿孔部位胃溃疡穿孔14例（28％），十二指肠溃疡穿孔31例（62％），胃空肠吻合口溃疡穿孔1例（2％），另有4例（8％）保守治疗治愈，未行内镜检查，穿孔部位不明回．3并发病情况41例（82％）并发一种和（或）一种以上其他病症．其中。心血管方面疾病28例（56％），呼吸系统疾病13例（26％），肝硬变3例（6％…     

胃镜检出老年消化性溃疡124例

目的:探讨老年消化性溃疡的临床特点.方法:回顾性分析我院内镜中心2007-01/2008-10经胃镜检出的的老年消化性溃疡患者,并与同期行胃镜检查的60岁以下的消化性溃疡患者进行对比.结果:老年组124例,胃溃疡61例,十二指肠球部溃疡51例,复合溃疡12例;中青年组100例,胃溃疡29例,十二指肠球部溃疡64例,复合溃疡7例.两组相比胃溃疡有显著差异( P<0.01).老年组胃体溃疡占胃溃疡的36.1%,直径>2cm的溃疡占29.5%,并发症以上消化道出血为主,占43.5%,均较中青年组有显著性差异( P<0.05).结论:老年消化性溃疡症状不典型,溃疡部位由幽门向贲门推移,且胃溃疡比十二指肠球部溃疡多,溃疡面积较大,合并症多且较严重.     

Epidemiology of peptic ulcer disease

In the United States about four million people have active peptic ulcers and about 350,000 new cases are diagnosed each year. Four times as many duodenal ulcers as gastric ulcers are diagnosed. Approximately 3000 deaths per year in the United States are due to duodenal ulcer and 3000 to gastric ulcer. There has been a marked decrease in reported hospitalization and mortality rates for peptic ulcer in the United States. Changes in criteria for selecting the underlying cause of death might account for some of the apparent decrease in ulcer mortality rates. Hospitalization rates for duodenal ulcers decreased nearly 50 per cent from 1970 to 1978, but hospitalization rates for gastric ulcers did not decrease. Although this decrease in hospitalization rates may reflect a decrease in duodenal ulcer disease incidence, it appears that changes in coding practices, hospitalization criteria, and diagnostic procedures have contributed to the reported declines in peptic ulcer hospitalization and mortality rates. There is no good evidence to support the popular belief that peptic ulcer is most common in the spring and autumn. The most consistent pattern appears to be low ulcer rates in the summer. There is strong evidence that cigarette smoking, regular use of aspirin, and prolonged use of steroids are associated with the development of peptic ulcer. There is some evidence that coffee and aspirin substitutes may affect ulcers, but most studies do not implicate alcohol, food, or psychological stress as causes of ulcer disease. Genetic factors play a role in both duodenal and gastric ulcer. The first-degree relatives of patients with duodenal ulcer have a two- to threefold increase in risk of getting duodenal ulcer and relatives of gastric ulcer patients have a similarly increased risk of getting a gastric ulcer. About half of the patients with duodenal ulcer have elevated plasma pepsinogen I. A small increase in risk of duodenal ulcer is found in persons with blood group O and in subjects who fail to secrete blood group antigens into the saliva. In most Western countries, morbidity from duodenal ulcer is more common than from gastric ulcer, even though deaths from gastric ulcer exceed or equal those from duodenal ulcer. In Japan, both morbidity and mortality are higher for gastric ulcer than for duodenal ulcer.     

Peptic Ulcer in Infants: Three Case Reports and a Review of the Japanese Literature

Abstract: Three cases of peptic ulcer in children under two years of age are reported, and 33 cases of infants with peptic ulcer reported in Japan between 1955 and March, 1989 are reviewed. Case 1 was an 8-month-old male complaining of melena, and endoscopic examination showed a gastric ulcer on the lesser curvature of the antrum. Cases 2 and 3 were a 15-month-old mule and an 18-month-old male, respectively, with complaints of melena and hematemesis. Endoscopic examination revealed an active duodenal ulcer in both cases. All 3 infants were successfully treated with H₂ blocker and/or antacid. In these 3 cases, infection or drugs were speculated to be predisposing factors, and the fathers of these three infants all had histories of duodenal ulcer. Among 33 cases of infants under 2 years old with peptic ulcer in Japan, 9 had a gastric ulcer and 24 had a duodenal ulcer. Seventeen were treated with conservative therapy and 16 were operated on because of perforation or bleeding. We should always keep in mind that peptic ulcer does occur in infancy, and that endoscopic examination should be promptly performed when peptic ulcer is suspected.     

Changing pattern of peptic ulcer in India. An endoscopic study of 1,188 ulcer patients.

Earlier studies have described a profile of peptic ulcer different in developing and developed countries. In a prospective endoscopic study in India over 5 years and 8 months involving 5,948 patients with upper gastrointestinal symptoms, we detected peptic ulcers in 1,188. There were 920 patients with duodenal ulcer (DU), 185 with gastric ulcer (GU), and 83 with combinations of the two. The male to female ratio was 4.2:1. About half the ulcers were in patients age greater than or equal to 40 years. Of the 223 (18.7%) patients with peptic ulcer complications, gastrointestinal bleeding was the most common (12.7%) and gastric outlet obstruction was less common (6.2%). Endoscopic evidence of duodenal bulb deformity was seen in 74.4% of DU patients. A comparison of these results with data from previous Indian studies suggests a changing trend of peptic ulcer with respect to age and sex distribution, the ratio between DU and GU, and complications of peptic ulcer. The profile of peptic ulcer in north India today is similar to that seen in Western countries four to five decades ago. We discuss possible factors responsible for this change.     

消化性溃疡并发出血1316例临床分析

目的探讨消化性溃疡并发出血的危险因素。方法回顾性分析我院１０年里消化性溃疡出血共１３１６例的临床资料。结果１３１６例中青壮年男性十二指肠溃疡患者并出血比例较女性、胃溃疡者多;体力劳动较脑力劳动者高。其次为血型、气候因素等也是影响消化性溃疡出血的因素。结论避免劳累、气温多变季节注意预防,能减少溃疡病出血。     

Publications on peptic ulcer in Britain,France, Germany and the US

OBJECTIVE : There are no reasonable explanations for the increases first of gastric, and then of duodenal, ulcers in the second half of the nineteenth century. Previous studies have analysed hospital admissions, necropsies and mortality data. This paper uses a novel method, a study of the rates of increases in publications on these peptic ulcers over the centuries in four countries, the US and three in Europe. METHODS : Between 1700 and 1919 the Surgeon General's Catalogues listed 2958 publications on gastric ulcer in Britain, France, Germany and the US, and between 1700 and 1929 1132 publications on duodenal ulcer. The published US cases of proven peptic ulcer in the nineteenth century were further analysed; details of sex, year of proven diagnosis and year of birth were available for 184 (90 male) cases of gastric ulcer and 77 (63 male) cases of duodenal ulcer. RESULTS : There were exponential increases in the number of monographs and articles on both types of peptic ulcer in the nineteenth century, and the curves for the four countries are remarkably similar. The increases in publications on gastric ulcer began about 1800 and for duodenal ulcer decades later. The number of cases of gastric ulcer diagnosed definitively in the US rose slowly in the first half of the nineteenth century and then increased markedly, with the increases in proven duodenal ulcer 10-20 years later. The birth years of patients with gastric ulcer peaked for those born in the 1850s, and about 10-20 years later for patients with duodenal ulcer. CONCLUSION : Such exponential increases are compatible with current models of infection with Helicobacter pylori but do not explain either the difference in timing between gastric and duodenal ulcer or the simultaneity between the four countries.     

Gastric cancer among peptic ulcer patients: Retrospective, long-term follow-up

BACKGROUND: Patients with duodenal ulcer are not at high risk although Helicobacter pylori infection is no doubt associated with gastric cancer development. However, little is known about the risk after long-term follow-up. AIMS: We investigated the incidence for gastric cancer development in peptic ulcer patients in a long term. PATIENTS AND METHODS: Between 1965 and 2004, endoscopic follow-up of more than 1 year was conducted on 1504 peptic ulcer patients in our hospital. They consisted of 978 gastric ulcer patients, 444 duodenal ulcer patients and 82 gastric and duodenal ulcer patients. Gastric and duodenal ulcer patients were excluded from the analysis because of their limited number. RESULTS: Gastric cancers developed in 32 (3.3%) of gastric ulcer patients and 3 (0.68%) of duodenal ulcer patients. Kaplan-Meier analysis showed that the incidence of gastric cancer in duodenal ulcer patients was significantly lower than that in gastric ulcer patients (log-rank test, p=0.0059). Cox's proportional hazard model denoted the relative risk for duodenal ulcer against gastric ulcer adjusted by sex and age as 0.23 (95% CI: 0.072-0.77, p=0.016). CONCLUSION: The risk for patients with duodenal ulcer to develop gastric cancer over the long term is significantly less than in those with gastric ulcer.     

The incidence of gastric ulcer and duodenal ulcer in north Norway. A prospective epidemiological study

From a prospective epidemiological study of peptic ulcer disease in the northern part of Norway, incidence rates for gastric and duodenal ulcer are presented. Over a 3-year period 4234 patients were examined radiologically or endoscopically. The population at risk was 72,537 persons, 16 to 93 years old. The yearly incidence rate for gastric ulcer in women was 0.9 per 1000 and for men 1.4 per 1000. For duodenal ulcer the incidence rates were 0.8 and 1.5 per 1000, respectively. The ratio of gastric ulcer to duodenal ulcer is still 1 to 1.1 for both sexes, 1 to 0.9 in women, and 1 to 1.14 in men in the northern part of Norway. Furthermore, the present study indicates a statistically significant positive correlation between increasing age and the occurrence of peptic ulcers for both sexes.     

Changes in peptic ulcer and gastritis/duodenitis in Great Britain, 1970-1985

The signal event of the 1970s in peptic ulcer disease was the introduction of H2 blockers. We examined changing direct and indirect effects of peptic ulcer and gastritis/duodenitis on the British population from 1970 to 1985. Death rates from gastric ulcer declined irregularly for all except women 65 years of age and older, in whom it increased, while for duodenal ulcer mortality declined only for men less than 65 years old and increased sharply for women 65 years and above. Mortality due to gastritis/duodenitis rose irregularly to 1980 and then fell inconsistently through 1985, and was but 1.0 to 1.5% that of peptic ulcer. Elderly women were disproportionately affected, much as with peptic ulcer. There was no significant change in essentially stable time trends for peptic ulcer perforation deaths. Hospitalizations for gastric and duodenal ulcer continued to fall through 1985 except for those age 65 years and above. Hospitalizations for peptic ulcer hemorrhage did not change overall, but the distribution favoring the elderly in the early 1970s reversed. Elderly men and women are now the most likely to bleed for both gastric and duodenal ulcer. Hospitalizations for gastritis/duodenitis increased for all populations. Peptic ulcer operations declined markedly for all groups, most for men and women less than 65 years old. Peptic ulcer as a cause of work loss declined sharply over time for men but was stable for women, while work loss due to gastritis/duodenitis plunged for both sexes beginning in 1979. Mean days off work per spell of absenteeism remained relatively constant: 35-45 days for peptic ulcer and 10-12 days for gastritis/duodenitis.(ABSTRACT TRUNCATED AT 250 WORDS)     

Prevalence of Peptic Ulcer in Dyspeptic Patients and the Influence of Age,Sex, and <Emphasis Type="Italic">Helicobacter pylori</Emphasis> Infection

We investigated the prevalence of peptic ulcer in dyspeptic patients in China to analyze the influence of age, sex, and Helicobacter pylori (H. pylori) infection. The results showed that the prevalence of gastric and duodenal ulcer increased with age. In patients under 60 years old, the prevalence of duodenal and gastric ulcers in females was markedly lower than that in males, especially the prevalence of duodenal ulcer. The prevalence of duodenal ulcer and gastric ulcer in H. pylori-infected patients was markedly higher than in patients without H. pylori infection. In the patients under 60 years old, sex differences were still seen in both H. pylori-positive and H. pylori-negative patients. The prevalence of gastric and duodenal ulcers was markedly increased with age in both H. pylori-positive and H. pylori-negative patients. Multivariate logistic regression analysis showed that age, male sex, and H. pylori infection were three independent risk factors for gastric and duodenal ulcers.     

Ventilatory function in chronic peptic ulcer. A controlled study of ventilatory function in patients with gastric and duodenal ulcer

The aim of this study was to determine if a defect in ventilatory function is present in patients with chronic peptic ulcer and if so, is it present in both gastric and duodenal ulcer and is it related to smoking. Fifty-six patients with peptic ulceration (27 gastric ulcer, 29 duodenal ulcer), together with 56 healthy controls matched for age, sex, and smoking status, were studied. Ventilatory function was measured and the ABH blood group antigen secretor status was determined. Vital capacity and forced expiratory volume in 1 s were significantly reduced in both smokers and nonsmokers with gastric ulcer when compared with controls; total lung capacity was lower than controls only in smokers with gastric ulcer. In duodenal ulcer patients, a trend similar to that observed in gastric ulcer patients was present. It is concluded that a defect in ventilatory function is present in patients with chronic gastric ulcer; a lesser defect is present in patients with duodenal ulcer.