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目的总结胃多发性溃疡的临床表现及胃镜结果。方法总结我们近4年经胃镜检出的胃多发性溃疡与胃单发性溃疡在流行病学、病因、临床表现、内镜结果、转归资料并进行比较,部分比较采用卡方检验。结果(1)本组发现胃多发性溃疡和单发性溃疡在性别方面无明显差别。胃多发性溃疡患者年龄在60岁以上占43.9%,且常同时患有慢性阻塞性肺炎、脑梗死、类风湿关节炎等慢性疾病,服用多种药物,和单发性溃疡老年组有明显差别。(2)本组胃多发性溃疡患者病史在1月以内多见,部分患者既往有反复发作病史。临床症状以剑突下疼痛、上腹胀痛为主。内镜多表现浅表,形态以圆形或卵圆形为主。主要分布在胃窦、胃角、胃体,与胃单发性溃疡分布部位相似,而其中以多个溃疡分布在同一部位或两个部位多见。溃疡个数以2个多见。(3)本组胃多发性溃疡随访均未见恶变者,且单发性溃疡组恶变率较高。(4)本组胃多发性溃疡患者幽门螺杆菌(Hp)阳性率为81.3%,与胃单发性溃疡Hp阳性率相近。(5)溃疡完全愈合率为73.7%。结论本组结果显示胃多发性溃疡好发于老年人,尤其患有多种慢性病服用多种药物者。病程短,易复发。对于内科治疗效果差、不典型增生者,应加强内镜的随访。
Objective To summarize the clinical manifestations and gastroscopy results of gastric multiple ulcer. Methods We summarize the epidemiology, etiology, clinical manifestations, endoscopic findings and outcome data of gastric ulceration and stomach ulcer detected by gastroscope in recent 4 years. Some of the data were compared by chi-square test. Results (1) This group found no significant difference in gender between gastric multiple ulcer and single ulcer. Gastric multiple ulcer patients over the age of 60 accounted for 43.9%, and often also suffer from chronic obstructive pneumonia, cerebral infarction, rheumatoid arthritis and other chronic diseases, taking a variety of drugs, and single ulceration in elderly patients were significantly different . (2) The history of patients with gastric multiple ulcer in the more common in January, some patients with recurrent past history. Clinical symptoms of xiphoid pain, abdominal pain based. Endoscopic multi-performance superficial, the shape of a round or oval-based. Mainly located in the antrum, stomach, stomach, gastric ulcer and gastric ulcer distribution similar to the distribution of multiple ulcers in the same site or two more common. The number of ulcers to 2 more common. (3) This group of patients with gastric ulcer were followed-up were not malignant, and single ulcer group higher rates of malignancy. (4) The positive rate of Helicobacter pylori (Hp) in this group of patients with gastric ulcer was 81.3%, which was similar to the positive rate of Hp in gastric ulcer. (5) ulcer complete healing rate was 73.7%. Conclusions This group of results show that multiple gastric ulcers occur in the elderly, especially those with multiple chronic diseases taking multiple drugs. Short course, easy to relapse. For poor medical treatment, atypical hyperplasia, endoscopic follow-up should be strengthened.