摘要
目的:调查分析拉萨地区消化性溃疡(PUD)患者的临床特征和诊疗表现.方法:回顾性分析2017年9月至2019年12月在拉萨市人民医院诊治的237例PUD患者,调查分析患者一般资料、临床表现、治疗和转归.结果:该地区PUD患者男性180例(占75.9%)多于女性57例(占24.1%),且长期吸烟89例(占37.6%)和大量饮酒70例(占29.5%)占一定的比例.常见的伴发疾病中慢性肝病39例(占16.5%),高血压24例(占10.1%),关节炎(痛风)8例(占3.4%).234例(占98.7%)PUD患者有临床症状,最常见的分别为腹痛200例(占84.4%),呕血或便血122例(占51.5%),烧心90例(占38.0%)和腹胀84例(占35.4%);多发溃疡131例(占55.3%)多于单个溃疡106例(占44.7%);发病部位由高向低依次是胃角124例(占52.3%)＞胃体72例(占30.4%)＞胃窦69例(占29.1%)＞幽门48例(占20.3%)＞十二指肠球部29例(占12.2%)＞胃底14例(占5.9%).能够追踪到治疗方案的235例患者中229例(占97.4%)接受了规范的抑酸治疗和胃黏膜保护剂.237例PUD患者中对166例进行了随访,161例提供症状反馈,其结果显示,158例(占98.1%)患者症状缓解或消失.166例受访患者中49例复查胃镜,其中11例(占22.4%)显示溃疡复发.研究期间166例受访患者中分别有7例(占4.2%)患者因PUD再次入院,7例(占4.2%)患者死亡,主要死亡原因涉及消化道出血、胃癌、胃相关疾病、肝癌和冠心病.结论:本研究结果提供了拉萨地区PUD的临床特征的重要信息,其预后研究有助于更好地了解该地区的PUD流行病学特点以及临床管理现状,但仍需要更大样本量和进一步研究来确认和扩展其研究结果.
Abstract
Objective:To investigate the clinical characteristics,and diagnostic and curative performance of patients with peptic ulcer disease(PUD)in Lhasa region.Methods:A retrospective analysis was conducted on 237 PUD patients who received diagnosis and treatment at Lhasa People's Hospital between September 2017 and December 2019.The general information of demographics,clinical presentations,treatment and outcomes of patients were investigated and analyzed.Results:In the PUD patients of this region,180 cases were male patients(75.9%),which was more than 57 female patients(24.1%),and 89 cases(37.6%)had smoking history with long term and 70 cases(29.5%)had history of heavy drinking.In the common comorbidities,39 cases(16.5%)were chronic liver disease,24 cases(10.1%)were hypertension,and 8 cases(3.4%)were arthritis(gout).Clinical symptoms presented in 234 PUD patients(98.7%),and the most common symptoms were respectively abdominal pain(200 cases,84.4%),hematemesis or melena(122 cases,51.5%),heartburn(90 cases,38.0%),and abdominal distension(84 cases,35.4%).The number of patients with multiple ulcers was 131 cases(55.3%),which was more than that of patients with single ulcers(106 cases,44.7%).The distribution of ulcer locations,from most to least frequent,was as follows:gastric angle(124 cases,52.3%),gastric body(72 cases,30.4%),antrum(69 cases,29.1%),pylorus(48 cases,20.3%),duodenal bulb(29 cases,12.2%)and gastric fundus(14 cases,5.9%).In the 235 patients whose treatment plans could be tracked,229 cases(97.4%)received standard acid-suppressive therapy and gastric mucosal protectant.In the 237 PUD patients,166 cases received follow-up,and 161 PUD patients provided feedbacks for symptom.The result showed that the symptoms of 158(98.1%)patients were alleviated or disappeared.In the 166 patients who received follow-up,49 cases underwent reexamination of endoscopy,and 11 cases(22.4%)of them appeared recurrence of ulcer.During the period of study,7 patients(4.2%)of 166 patients who received follow-up re-admitted to hospital due to PUD,and 7 patients(4.2%)died,and the main reasons of death involved to gastrointestinal bleeding,gastric cancer,stomach-related diseases,liver cancer,and coronary heart disease.Conclusion:The result of this study provided important information of clinical characteristics of PUD in the Lhasa region.The prognostic research of that is helpful to better understand the epidemiological characteristics and the status of clinical management for PUD in this region.However,this study still need larger sample size and further research to confirm and expand these results.
基金项目
西藏自治区自然科学基金组团式医学援藏项目(XZ2020ZR-ZY28Z)
维普
万方数据