消化性溃疡出血危险因素探究

目的探究导致消化性溃疡出血的危险因素。方法选择2009年5月～2012年1月来就诊的消化性溃疡患者820例,对每位患者以下8个临床特征进行采集,主要包括:吸烟、饮酒、性别、出现首发症状的年龄、病程、主要症状(腹痛、反酸、腹胀、呕吐等)、溃疡的大小、溃疡的数目(单或者多发)。结果经过统计学对GU和DU分别检验各自出血组和无出血组在既往出血史、服用NSAID药物方面比较差异均无统计学意义(P>0.05),其他变量在GU或DU中差异有统计学意义(P<0.05)。结论通过上述变量的研究及统计学相关分析,对以上临床特征研究、总结,可以积极有效的指导患者避免出血的发生     

诺氟沙星致过敏性皮疹一例报道

幽门螺杆菌(HP)与消化性溃疡(PU)明显相关。PU 患者 HP 阳性率很高,胃溃疡(GU)多为70～80%,十二指肠球部溃疡(DU)则高达80～100%。其中 HP 阳性患PU 的危险性大,且 HP 阳性 DU 比 HP 阴性DU 易复发。目前则趋向认为在 DU 的形成     

某县消化性溃疡的流行病学分析

目的了解本地区消化性溃疡的临床流行病学特点。方法对我院8年间胃镜诊断为消化性溃疡的病例进行回顾性分析。结果在15146例胃镜检查患者中检出消化性溃疡(PU)2170例,检出率为14.33%,其中十二指肠球部溃疡(DU)1456例,占67.1%;胃溃疡(GU)584例,占26.9%;其他溃疡130例,占6.0%。男女之比为2.27∶1;DU发病部位以球部前壁最多,占56.25%;GU发病部位以胃窦部最多,占64.21%。结论本地区PU检出率为14.33%,年段检出率有下降趋势。男性PU的发病率高于女性,DU患者多于GU患者,GU以中老年为主,DU发病部位以球部前壁最多,GU发病部位以胃窦部最多。     

3 826例消化性溃疡胃镜及流行病学分析

目的:调查本地区消化性溃疡(PU)的流行病学状况。方法:对我院近5年来经胃镜检查证实的3826例PU进行回顾性分析。结果:(1)PU总检出率为21.5%;胃溃疡(GU)和十二指肠溃疡(DU)检出率分别为15.2%、78.2%;DU与GU之比为5.15∶1。(2)PU检出男女之比为1.83:1;PU以中青年好发,青少年组以DU为主(86.6%),中年组和老年组GU检出率逐渐上升(分别P<0.01),而DU检出率逐渐下降(分别P<0.01);PU以冬春季节多发。(3)上消化道出血是PU最常见的并发症;DU并发出血率高于GU(P<0.01),并发穿孔率低于GU(P<0.05)。(4)GU好发于胃角和胃窦,DU好发于球部前壁和大弯侧;二者均以单发、小溃疡多见。(5)幽门螺杆菌(HP)总检出率为85.2%;DU的HP检出率(88.5%)明显高于GU(71.2%)(P<0.01)。结论:流行病学调查对于PU的防治具有一定的指导意义。     

胃康灵胶囊治疗消化道溃疡84例疗效观察

笔者自2003年1月至2005年4月对84例消化性溃疡出血的患者用胃康灵(黑龙江葵花药业股份有限公司生产)治疗并观察其疗效,现将结果报告如下:1资料与方法1.1临床资料本组共84例消化道溃疡出血住院患者,其中男56例,女28例,男女之比为2∶1;年龄18～60岁,平均38岁。平均病程为6.4年。所有患者均由我院内镜室行胃镜检查,证实为胃溃疡、十二指肠球部溃疡或复合性胃和十二指肠溃疡。胃溃疡36例(42.9%),溃疡个数42个,溃疡平均直径(0.45±0.15)cm;十二指肠球部溃疡42例(50.0%),溃疡个数46个,平均直径(0.75±0.20)cm;胃、十二指肠溃疡6例(7.1%),溃疡个数1…     

银川市消化性溃疡患者的胃镜及临床特点分析

目的 研究银川市第一人民医院近一年来消化性溃疡(peptic ulcer,PU)患者的胃镜及临床特点.方法 对2010年4月至2011年4月经胃镜检查诊断为PU的患者资料进行回顾性分析.结果 (1)4294例患者共检出PU518例,检出率为12.06％,其中十二指肠溃疡(duodenal ulcer,DU )328例,占63.32％;胃溃疡(gastric ulcer,GU)170例,占32.82％;复合溃疡20例,占3.86％.DU与GU之比为1.93:1.(2)溃疡患者男女之比为2.36:1.(3)GU发病部位以胃窦及胃角最多,为108例(63.53％),其次为胃体45例(26.47％),胃底17例(10.00％);DU的发病部位以球部前壁最多,为174例(53.05％),其次为大弯67(20.43％),小弯56例(17.07％),后壁25例(7.60％),球后6例(1.80％).结论 (1)PU检出情况,DU明显多于GU,复合溃疡最少;(2)PU患者男性明显多于女性;(3)DU的好发部位是十二指肠球部前壁,GU的好发部位是胃角和胃窦.     

60例消化性溃疡伴出血护理体会

1　一般资料我院从 1995～ 2 0 0 2年间共收治消化性溃疡伴出血 6 0例 ,其中男性 4 0例 ,女性 2 0例 ;年龄为 30～ 6 0岁 ,平均 4 8岁 ;十二指肠球部溃疡 (DU) 4 0例 ,胃溃疡 (GU) 16例 ,复合性溃疡 4例 ;5 6例经胃镜确诊 ,另外 4例由钡检发现龛影确诊。胃小弯的溃疡占 18例 ,占胃溃疡和复合性溃疡的 70 % ;DU及复合性溃疡伴出血发生于前壁 15例 ,大弯侧 13例 ,前壁和大弯侧共占 6 0 %。中等深度以上的溃疡占 18例。伴有胆道疾病 12例 ,慢性胃炎 10例 ,高血压 10例 ,冠心病 8例 ,糖尿病 10例 ,肝硬化 3例 ,乙肝 6例 ,直肠癌 1例 ,其中合…     

老年消化性溃疡78例分析

目的分析老年人消化性溃疡临床特征。方法将同期收治确诊的78例老年消化性溃疡病例与78例中青年消化性溃疡患者的临床情况进行对比分析。结果老年患者胃痛多不典型,而节律性空腹痛仅占21.8%,与中青年人组55.1%相比有非常显著差异(P<0.01)。十二指肠溃疡(DU)与胃溃疡(GU)发病比例,老年组0.71:l,中青年组2.75:1,两组有非常显著性差异(P<0.01)。溃疡发生部位老年组胃体部溃疡、贲门胃底溃疡、巨大溃疡均明显高于非老年组,且伴随症状多见,并发症两组无明显差异(P>0.05)。结论老年患者胃溃疡多于十二指肠球部溃疡,发生胃体部溃疡、贲门胃底溃疡、巨大溃疡较多,且症状多不典型,有节律性空腹痛者远低于非老年组患者。     

幽门螺杆菌与门脉高压性胃病及溃疡病的关系分析

目的探讨幽门螺杆菌(HP)与肝硬化并发胃及十二指肠病变的关系。方法对193例肝硬化患者HP感染进行检测并分析HP感染与门脉高压性胃病(PHG)及肝源性溃疡的关系。结果肝硬化患者HP感染率与慢性胃炎(CG)接近;HP感染率在肝硬化有、无PHG及轻、重型PHG组间无显著差异;肝硬化伴十二指肠溃疡(DU)组HP感染率高于不伴溃疡组而与DU对照组接近;肝硬化伴胃溃疡(GU)组HP感染率与不伴溃疡组无显著差异,而显著低于GU对照组。结论肝硬化患者,HP与DU关系密切,而与PHG及GU无显著关系。     

洛赛克加羟氨苄青霉素治疗消化性溃疡（附34例报告）

笔者自1993年起应用H~+-K~+-ATP酶抑制剂(洛赛克)加羟氨苄青霉素治疗消化性溃疡34例,疗效满意,报道如下。1 临床资料1.1 本组34例均经纤维胃镜诊断为消化性溃疡。其中男25例,女9例。十二指肠球部溃疡(DU)23例,胃溃疡(GU)11例。年龄17—59岁,病程5个月至19年。其中不全梗阻者4例,便潜血阳性者17例,呕血者3例。     

奥美拉唑对65例消化性溃疡的疗效

奥美拉唑20mg,qd,口服治疗活动性胃或十二指肠溃疡65例(Ome组:男59,女6;年龄41±13a)。雷尼替丁0.15g,bid,口服,治疗42例(Ran组:男39,女3;年龄42±11a)作比较。疗程4-6wk。服药后疼痛消除:Ome组90％在3d内,Ran组92％需7-8d。十二指肠溃疡愈合率:Ome组(43例)4wk达100％,Ran组(30例)70％(P<0.01),胃溃疡愈合率:Ome组(22例)6wk为95％,Ran组(12例)67％(P<0.01)     

3250例消化性溃疡的电子胃镜检查分析

目的了解新疆地区消化性溃疡（PU）的发病情况及内镜下特点。方法分析新疆医科大学第一附属医院2000年12月至2005年2月间胃镜检查消化性溃疡的临床资料。结果在18560例胃镜检查中,检出3250例PU,检出率为17.5%,其中,胃溃疡（GU）2150例,十二指肠溃疡（DU）884例,复合性溃疡（CU）216例。结论PU的患者男性多于女性;DU多于GU;DU好发的部位是十二指肠球前壁;GU的好发部位是胃角和胃窦;PU合并疾病多;四季的检出率相差不大。     

某地军人消化性溃疡流行病学分析

目的了解某地部队官兵消化性溃疡的发病情况和流行病学特点。方法对2001年1月至2010年12月经胃镜检查确诊为消化性溃疡的病例进行统计分析。结果共检出1312例军人消化性溃疡(PU),其中十二指肠溃疡(DU)1114例,胃溃疡(GU)173例,复合性溃疡(CU)25例。幽门螺杆菌(Hp)感染率74.47%。PU检出率以冬春季最高,夏季最低。结论军人PU以DU最多,GU次之,CU最少;发病有明显季节性,并与军事训练密切相关。     

消化性溃疡299例临床特点分析

目的探讨消化性溃疡的病因分布特点。方法回顾分析我院2008年消化性溃疡住院患者的临床资料。结果（1）共检出消化性溃疡患者299例。十二指肠溃疡（DU）168例、胃溃疡（GU）81例、复合性溃疡（CU）45例、吻合口溃疡（SU）5例。（2）299例中男206例,女93例,男女之比为2．21：1。（3）各种消化性溃疡的幽门螺杆菌（Hp）阳性率不同（P〈0．05）。（4）消化性溃疡合并出血的Hp阳性率为94．50％,不合并出血的Hp阳性率为71．05％（P〈0．05）。（5）消化性溃疡患者发病平均年龄DU为42．5岁,GU为48．5岁,CU为50．1岁,SU为54．5岁。结论消化性溃疡的发病以DU多见,男性发病率多于女性,溃疡合并出血者Hp阳性率高,复合溃疡Hp阳性率最高。     

四联疗法治疗上消化道溃疡的临床疗效

目的:观察奥美拉唑与阿莫西林、呋喃唑酮、胶态果胶铋剂四联治疗上消化道溃疡的疗效.方法:采用随机分组平行对照法,全组共100例,对照组用奥美拉唑20mg/d,共4wk;治疗组(四联疗法)采用奥美拉唑20mg/d,阿莫西林500mg tid,呋喃唑酮200mg tid,胶态果胶铋剂100mg tid,共2wk.结果:溃疡痊愈率治疗组为100%,对照组为92.0%(P>0.05)IIP根除率治疗组为93.88%,对照组为28.57%(P相似文献   

埃索美拉唑短程三联疗法治疗老年消化性溃疡的临床观察

目的观察埃索美拉唑短程三联疗法对幽门螺杆菌(Hp)相关性老年消化性溃疡病的治疗效果。方法选取55例Hp阳性,年龄在60岁以上的消化性溃疡患者,随机分成两组。第1组:Hp阳性的十二指肠溃疡患者,第2组:Hp阳性的胃溃疡患者。分别予以埃索美拉唑20 mg,阿莫西林1 000 mg,呋喃唑酮100 mg,每日2次,疗程7 d。观察各组患者症状缓解情况,Hp根除率,不良反应及溃疡愈合率。结果各组患者症状在1~3d内缓解,Hp根除率第1组、第2组分别为91%、94%。溃疡愈合率分别为95%、91%。结论埃索美拉唑联合治疗老年性消化性溃疡1周方案,Hp根除率高,顺从性和耐受性好。     

Non-steroidal anti-inflammatory drugs, Helicobacter pylori and bleeding gastric ulcer

BACKGROUND: Helicobacter pylori infection and NSAID usage are considered to be independent risk factors for gastric ulcer (GU). Whether they interact to influence the risk of bleeding in GU is unclear. AIM: To determine the prevalence of H. pylori infection and NSAID ingestion in a group of patients with GU and determine their roles in bleeding and non-bleeding GU. METHODS AND RESULTS: From January 1993 to June 1996, a total of 217 GU patients (150 male, 67 female, median age 61 years, range 26-94) were eligible for the study. Eighty-five per cent were H. pylori-positive and 15% were H. pylori-negative. NSAID usage within 4 weeks prior to endoscopy was present in 30%, more in the H. pylori-negative than H. pylori-positive patients (59% vs. 25% P = 0.0002). Aspirin was most commonly used (43%). One hundred patients bled from GU (69 male, 31 female, mean age 67 years, range 26-94) and 117 did not (81 male, 36 female, mean age 57 years, range 28-86). Univariate logistic regression showed that advanced age (>/= 65 years) and NSAID usage carried an increased risk of bleeding GU (odds ratio 3.4 and 6.8, respectively) while H. pylori infection alone was not associated with additional risk (OR = 0.8). However, when three variables were considered jointly in a multiple logistic regression, the OR associated with H. pylori infection increased to 2.4, suggesting that in the presence of NSAIDs and advanced age, H. pylori also increases the risk of bleeding GU, indicating an interaction between the variables. CONCLUSION: NSAID usage and advanced age are risk factors for bleeding GU, whereas H. pylori infection by itself is not. In the presence of NSAIDs and advanced age, an increased risk of bleeding GU with H. pylori is observed, indicating the possibility of an interaction between these factors.     

Peptic ulcer therapy with cimetidine versus tripotassium dicitrato bismuthate in rheumatoid arthritis patients undergoing chronic NSAID treatment

Aim:

To compare the efficacy of cimetidine and tripotassium dicitrato bismuthate (TDB) in arthritic patients who had developed gastric (GU) or duodenal (DU) ulceration while taking non-steroidal anti-inflammatory drugs (NSAIDs).

Methods:

Eighty-six rheumatoid arthritis (RA) patients affected by endoscopically proven DU (n = 44) or GU (n = 42), and on chronic NSAID therapy which was not suspended during anti-ulcer therapy, were randomized to cimetidine (400 mg t.d.s.) or TDB (120 mg q.d.s.). A repeat endoscopy was planned after 4 weeks (and 8 weeks, in case of failed healing). The patients who were unhealed after 8 weeks of therapy were allocated to the alternative anti-ulcer drug for a further 8 weeks without interrupting the anti-inflammatory therapy.

Results:

At week 4 of therapy, 14/24 (58%) DU and 9/20 (45%) GU patients treated with cimetidine were healed, compared with 12/20 (60%) and 10/22 (45%) TDB-treated patients (N.S.). At week 8 of therapy, the DU healing rates were 15/24 (63%) with cimetidine and 14/20 (70%) for TDB. The corresponding GU healing rates were 12/20 (60%) with cimetidine and 13/22 (60%) for TDB (N.S.). At week 16, complete healing with cimetidine was observed in 67% of DU and 57% of GU patients unhealed with TDB; the corresponding figures in the patients crossed to TDB were 83% for DU and 63% for GU patients (N.S. vs. cimetidine).

Conclusions:

No statistically significant difference was found between the healing activities of cimetidine and TDB in rheumatoid arthritis patients with peptic ulcer who did not interrupt their NSAID treatment for arthritis. This trial showed that the continued consumption of NSAIDs appears to slow the ulcer healing process, especially in GU patients.