Department of Surgery, Chinese University of Hong Kong, Hong Kong, SAR, China.
Digestion. 2011;84(2):102-13. doi: 10.1159/000323958. Epub 2011 Apr 14.
BACKGROUND/AIMS: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events.
Systematic PubMed searches.
Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4-57.0 and 3.8-14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9% (95% CI: 8.4-19.4), and the average long-term recurrence of perforation was 12.2% (95% CI: 2.5-21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≥1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6% (95% CI: 5.8-11.4) after hemorrhage and 23.5% (95% CI: 15.5-31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality.
Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.
背景/目的：近年来，无并发症消化性溃疡的发病率有所下降。目前尚不清楚这对消化性溃疡并发症的流行病学有何影响。本系统综述旨在确定复杂消化性溃疡的发生率、复发率和死亡率，以及与这些事件相关的危险因素。
系统地进行了 PubMed 检索。
共确定了 93 项研究。消化性溃疡出血和穿孔的年发生率估计分别为 19.4-57.0 和 3.8-14/10 万人。出血的 7 天平均复发率为 13.9%（95%CI：8.4-19.4），穿孔的长期平均复发率为 12.2%（95%CI：2.5-21.9）。消化性溃疡并发症及其复发的危险因素包括非甾体抗炎药和/或乙酰水杨酸的使用、幽门螺杆菌感染和溃疡直径≥1cm。质子泵抑制剂的使用降低了消化性溃疡出血的风险。出血后 30 天的平均死亡率为 8.6%（95%CI：5.8-11.4），穿孔后为 23.5%（95%CI：15.5-31.0）。年龄较大、合并症、休克和延迟治疗与死亡率增加相关。
复杂消化性溃疡仍然是一个严重的医疗保健问题，使患者面临反复发生并发症和死亡的高风险。
