BACKGROUND:Hp and NSAID are considered as major pathogens in peptic ulcerations and their complications but little is known about the incidence of ulcers and their complications following wide-spread use of Hp eradication. The aims of the study were: 1) to analyze incidence of ulcers and their complications, bleeding and perforations at time when the Hp eradication has been used in ulcer therapy, and 2) to assess the impact of Hp infection and NSAID use on the incidence of ulcers and complications.

MATERIAL/METHODS:From 1996 to 2001, 381 patients with complications of peptic ulcers were admitted to the emergency surgery, including 273 patients with bleeding ulcers and 108 with perforations out of a sample of 6515 dyspeptic patients examined with upper endoscopy and 13C-urea breath test (UBT).

RESULTS:The rate of ulcer bleeding and perforations, remained relatively constant throughout the study period. NSAID use in that group increased form 15.8% in 1999 to 19.4% in 2001. The incidence of Hp in patients with complications assessed by UBT or CLO was 76.7%, while the incidence of Hp in 7920 patients ranged form 72.8% in 1996 to 53.8% in 2001. There were 1940 (29.7%) patients with duodenal and/or gastric ulcer diagnosed by upper gastroscopy. The decline in the prevalence of peptic ulcer from about 44% to 8% occurred over the same time. A slight increase in the number of ulcer resulting from NSAID use was observed so was the number of ulcers without Hp or NSAID (idiopathic).

CONCLUSIONS:Despite decreased Hp prevalence, the incidence of ulcers complications remained unchanged probably due to increased use of NSAID and the appearance of idiopathic ulcers.

译文

背景:Hp和NSAID被认为是消化性溃疡及其并发症的主要病原体,但对于广泛使用Hp根除后溃疡的发生率及其并发症知之甚少。该研究的目的是:1)分析在溃疡治疗中使用Hp根除时溃疡的发生率及其并发症,出血和穿孔,以及2)评估Hp感染和NSAID的使用对发病率的影响

材料/方法:从1996年到2001年,有381例消化性溃疡并发症的患者被紧急救治,其中273例出血性溃疡和108例溃疡性溃疡。从6515名消化不良患者的样本中穿孔进行了上内镜检查和13C尿素呼气试验(UBT)。

结果:溃疡出血和穿孔的发生率在整个过程中保持相对恒定学习期间。在该组中,NSAID的使用率从1999年的15.8%增加到2001年的19.4%。通过UBT或CLO评估的并发症患者中Hp的发生率为76.7%,而7920名患者中Hp的发生率在1996年为72.8%至53.8。在2001年为%。有1940例(29.7%)上腹部胃镜检查诊断为十二指肠和/或胃溃疡患者。消化性溃疡的患病率从大约44%下降到8%。使用非甾体抗炎药引起的溃疡数目略有增加,而没有Hp或NSAID(特发性)的溃疡数目也有所增加。

结论:尽管Hp患病率降低,但发病率溃疡并发症的发生率保持不变可能是由于增加了NSAID的使用和特发性溃疡的出现。

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