摘要
The aim of this study was to investigate the trends and clinical presentation of peptic ulcer perforation before and after the introduction of more effective ulcer therapy, including proton pump inhibitor and eradication of Helicobacter pylori. We retrospectively reviewed the charts of patients admitted to Mackay Memorial Hospital for perforated peptic ulcer from 1985-7 (Group 1) and 2000-2 (Group 2). 188 and 158 patients were included in group 1 and group 2, respectively. Mean age was 47.2±14.8 years in group 1 and 51.8±14.4 years in group 2 (p=0.017). There was a two-fold increase in the incidence of elderly patients (＞70 years) with ulcer perforation in the recent period (p=0.014). About 50% of patients in each group had a past history of peptic ulcer disease. The majority of patients (85.6% in group 1 and 80.3% in group 2) presented to the emergency room with acute abdominal pain. There was a significant increase in the proportion of perforated ulcers in the stomach in group 2 compared with group 1(p＜0.005). In addition, there were no significant differences in the mortality between the two study periods. In conclusion, the proportion of elderly patients with perforated peptic ulcers in recent years has been increased. There has also been an increase in the ratio of gastric perforation compared with duodenal perforation.
並列摘要
The aim of this study was to investigate the trends and clinical presentation of peptic ulcer perforation before and after the introduction of more effective ulcer therapy, including proton pump inhibitor and eradication of Helicobacter pylori. We retrospectively reviewed the charts of patients admitted to Mackay Memorial Hospital for perforated peptic ulcer from 1985-7 (Group 1) and 2000-2 (Group 2). 188 and 158 patients were included in group 1 and group 2, respectively. Mean age was 47.2±14.8 years in group 1 and 51.8±14.4 years in group 2 (p=0.017). There was a two-fold increase in the incidence of elderly patients (＞70 years) with ulcer perforation in the recent period (p=0.014). About 50% of patients in each group had a past history of peptic ulcer disease. The majority of patients (85.6% in group 1 and 80.3% in group 2) presented to the emergency room with acute abdominal pain. There was a significant increase in the proportion of perforated ulcers in the stomach in group 2 compared with group 1(p＜0.005). In addition, there were no significant differences in the mortality between the two study periods. In conclusion, the proportion of elderly patients with perforated peptic ulcers in recent years has been increased. There has also been an increase in the ratio of gastric perforation compared with duodenal perforation.