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摘要：目的
探讨昆明地区消化性溃疡（peptic ulcer,PU）的流行病学现况及临床意义。方法 应用流行病学方法对我院1973年12月至2000年12月间胃镜检查的80517例确诊为PU的8398例相关资料进行分析。结果
PU检出率为10.43%，其中十二指肠溃疡（duodenal ulcer,DU）5963例（71.01%），胃溃疡（gastric
ulcer,GU）1849例（22.02%），复合性溃疡（complex ulcer,CU）586例（6.97%）。DU与GU之比为3.22∶1。DU男4592例（77.01%），女1371例（22.99%），男女之比为3.35∶1。GU男1405例（75.98%），女444例（24.01%），男女之比为3.16∶1。CU男480例（81.91%），女106例（18.09%），男女之比为4.53∶1。三种类型溃疡发病男人性别比较差异显著（P<0.01）。DU发病年龄较GU早10年。PU发病季节性差异无显著性（P>0.05）。DU易发部位依次为球部前壁（54.62%）、大弯（21.22%）、小弯（12.61%）、后壁（9.44%）、球后（2.11%）。GU部位为胃角（45.16%）、胃窦（32.23%）、胃体（18.33%）、胃底贲门（4.23%）。在5122例有并发症的PU中以出血最多1211例（23.64%），幽门梗阻134例（2.61%），穿孔56例（1.09%），癌变23例（0.45%）。上消化道出血中以青年DU最常见，老年PU与青年比较发现穿孔及癌变率增高（P<0.01）。结论
1.昆明地区PU检
出率为10.43%，PU发病男性高于女性，DU高于GU。2.昆明地区PU发病无季节性差异。3.表明高危人群中定期胃镜随访，对早期诊断及治疗很有价值。
关键词：消化性溃疡；流行病学；十二指肠溃疡；胃溃疡
[Abstract]Objective To investigate the epidemiological characteristics
and clinical significance of peptic ulcer in the Kunming area.Methods
Using clinical epidemiological methods,80571 cases investigated by
endoscopy,8398 cases which were diagnosed as peptic ulcers(PU)were
analysed in the Kunming general hospital between December,1973 and
December,2000.Results The rate of detextion of PU was 10.43%.Among
these,5963 cases(71.01%)were duodenal ulcers(DU),1849 cases(22.02%)were
gastric ulcers(GU),586cases(6.97%)were complex ulcers(CU),The ratio
of DU and GU was 3.22∶1 In DU and GU cases,male and female ratios
of incidence were 3.35∶1 and 3.16∶1,respectively,while incidence in
CU cases was 4.53∶1.Males and females have significantly differed
in incidence of PU diseases(P<0.01).Regarding age of incidence,54.18%
of patients experiencing GU were over 50 years in age,while 32.42%
of DU patients were between 30 and 40 years.The total average age
of DU incidence wad 34.1 years.DU emerges two dexades earlier than
GU.There was no significant difference of inciderce of PU detected
in any season of the year(P>0,05).Regarding the location of ulcers,in
DU they were on the anterior wall of bulb 54.62%,greater curvature
21.22%,lesser curvature 12.61%,posterior wall 9.44%,postbulbar 2.11%;In
GU they were found on angular 45.16%,antral 32.23%,corporal 18.33%
and fundic 4.28%.5122 patients experienced complications,as follows:1211
patients(23.64%)experienced bleeding,perforations occurred in 56 patients(1.09%),134
patients(2.61%)experienced pyloric obstructions,and 23 patients(0.45%)experienced
malignant changes.Upper gastrointestinal(GI)bleeding in DU cases was
most prevalent among middles age and young patients.Perforations and
malignant changes were increased in elderly PU patients compared with
younger subjects(P<0.01).Conclusion The total rate of detection
of PU in the Kunming area was 10.43%,Total incidence of PU was higher
in mer than in woman,and DU inciderce was higher than GU.Moreover,there
was no significant difference of PU incidence relative to time of
year.Rates of malignant changes were highest in older PU patients,which
implies that follow-up endoscopy after the initial endoscopy should
be effective in early diagnosis and prevention among people of high
risk.
[Key words]Peptic ulcer;Epidemiological analysis;Duodenal ulcer;Gastric
ulcer
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