Department of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden.
Aliment Pharmacol Ther. 2009 Aug 15;30(4):392-8. doi: 10.1111/j.1365-2036.2009.04058.x. Epub 2009 Jun 6.
The incidence of peptic ulcer disease was expected to decrease following the introduction of acid inhibitors and Helicobacter pylori eradication.
To analyse possible changes in the incidence of bleeding peptic ulcer, treatment and mortality over time.
Residents of Malmö hospitalized for bleeding gastric or duodenal ulcer disease during 1987-2004 were identified in hospital databases (n = 1610). The material was divided into 6-year periods to identify changes over time. All patients who had been submitted to emergency surgery (n = 137) were reviewed.
The incidence rate for bleeding gastric or duodenal ulcers decreased by one half in males and by one-third in females and emergency operations decreased significantly (9.2%, 7.5% and 5.7% during the three time periods, respectively (P < 0.05). The post-operative mortality tended to decrease (9.7, 2.4 and 3.7%, respectively) and the 30-day mortality rates in the whole material were 1.2%, 3.6% and 3.4% during the different time periods.
The incidence of bleeding gastric and duodenal ulcer disease has decreased markedly. Operative treatment has been replaced by endoscopic treatment. The bleeding ulcer-related mortality was less than 4% and has not changed over time.
胃酸抑制剂和幽门螺杆菌根除的引入预计会降低消化性溃疡病的发病率。
分析出血性消化性溃疡的发病率、治疗方法和死亡率随时间的变化趋势。
从医院数据库中确定了 1987 年至 2004 年期间因出血性胃或十二指肠溃疡住院的马尔默居民（n=1610）。将资料分为 6 年时间段，以确定随时间的变化。对所有接受急诊手术的患者（n=137）进行了回顾性分析。
男性出血性胃或十二指肠溃疡的发病率下降了一半，女性下降了三分之一，急诊手术显著减少（三个时间段分别为 9.2%、7.5%和 5.7%（P<0.05）。术后死亡率呈下降趋势（分别为 9.7%、2.4%和 3.7%），整个资料的 30 天死亡率在不同时间段分别为 1.2%、3.6%和 3.4%。
出血性胃和十二指肠溃疡病的发病率显著下降。手术治疗已被内镜治疗所取代。与出血性溃疡相关的死亡率小于 4%，且随时间变化不大。
