Güzel Hakan, Kahramanca Sahin, Şeker Duray, Özgehan Gülay, Tunç Gündüz, Küçükpınar Tevfik, Kargıcı Hülagü
Department of General Surgery, Dışkapı Yıldırım Beyazıt Teaching and ResearchHospital, Ankara, Turkey.
Turk J Gastroenterol. 2014 Apr;25(2):152-5. doi: 10.5152/tjg.2014.5526.
BACKGROUND/AIMS: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications.
This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012.
In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001).
From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.
背景/目的：近年来消化性溃疡疾病的发病率和患病率有所下降，但考虑到消化性溃疡并发症时，得出相同结论并非易事。本研究的目的是确定复杂性消化性溃疡疾病的时间趋势，并阐述H2受体阻滞剂、质子泵抑制剂（PPI）和幽门螺杆菌根除疗法对这些并发症的影响。
本研究回顾性评估了过去50年因消化性溃疡并发症（穿孔、出血和梗阻）接受手术治疗的患者。根据引入H2受体阻滞剂、PPI和幽门螺杆菌根除方案的日期，将患者分为四组（G1-G4）。研究的时间段为：（G1）1962-1980年，（G2）1981-1990年，（G3）1991-1997年，以及（G4）1998-2012年。
共有2953例患者因消化性溃疡疾病并发症接受手术治疗，其中86%为男性。在G1组中，穿孔和梗阻是最常见的并发症（p<0.001），其次是出血。在G2组和G3组中，梗阻仍然是需要手术治疗的最常见并发症（p<0.001）。在G2组和G3组中，梗阻之后分别是穿孔和出血。在G4组中，穿孔是最常见的并发症（p<0.001）。
1962年至1990年，梗阻是需要手术治疗的最常见并发症。在过去十年中，穿孔成为最常见的并发症。与文献报道相反，在土耳其，出血是需要手术治疗的最不常见并发症。
