1 概述 1.1 定义 肝硬化容易发生消化性溃疡,临床上有肝源性溃疡(Hepatogenic ulcer)之称。由于原发疾病的存在,常缺乏溃疡病的典型症状,加之内镜检查受到一定限制,易造成误诊。溃疡部位以十二指肠球部多见,容易出血,不如食管静脉曲张破裂出血凶猛,休克发生率较高,大量出血与食管静脉曲张程度关系不密切,但大量出血易诱发肝性脑病,其死亡率较单纯消化性溃疡出血高4～5倍。 1.2 发病概况 文献报道肝源性溃疡发病率为5～15％,较社会人群高2～3倍。小林迪夫报道151例肝硬 1 Overview 1.1 Definitions Liver cirrhosis prone peptic ulcer, clinically known Hepatogenic ulcer. Due to the existence of the primary disease, often the lack of typical symptoms of ulcer disease, combined with endoscopic examination subject to certain restrictions, can easily lead to misdiagnosis. More common ulcers to the duodenal bulb, easy bleeding, as esophageal variceal bleeding fierce, high incidence of shock, a large number of bleeding and esophageal varices is not closely related to the degree, but a large number of bleeding induced hepatic encephalopathy, its Mortality than simple peptic ulcer bleeding 4 to 5 times higher. 1.2 incidence profile The incidence of liver ulcer reported in the literature for 5 to 15%, 2 to 3 times higher than the social population. Kobayashi reported 151 cases of liver cirrhosis