Bardhan K D, Cust G, Hinchliffe R F, Williamson F M, Lyon C, Bose K
District General Hospital, Rotherham, UK.
Br J Surg. 1989 Mar;76(3):230-6. doi: 10.1002/bjs.1800760307.
The admission rates for duodenal ulcer (DU) and the effect of H2-receptor antagonists (H2RA), introduced in the Trent Region of the UK in 1977, were examined. The admission rates are expressed per 10(6) of resident population. The use of H2RA has risen 3.7-fold (from 1978 to 1983), yet overall admission rates for perforation have changed little: 99 in 1972-76 (pre-H2RA period) compared with 103 in 1977-84 (H2RA period). Admission rates for haemorrhage have risen by 8 per cent, from 130 to 140 (P less than 0.01). However, the overall rates conceal large increases (P less than 0.01) in the admission rates for those aged greater than or equal to 65 years, of 33 per cent (from 264 to 352) for perforation and of 28 per cent (from 381 to 489) for haemorrhage. Emergency admissions for uncomplicated DU were unchanged: 88 in 1972-76 and 89 in 1977-84. However, the proportions operated on fell by 58 per cent (P less than 0.01), from 30 per cent of admissions in the pre-H2RA period compared with only 12 per cent in the H2RA period. Waiting-list admissions for uncomplicated DU fell by 43 per cent, from 187 to 106 (P less than 0.01), and the proportions operated on fell from 162 to 76; the combined effect resulted in a reduction of 53 per cent in the operation rates (P less than 0.01). In Rotherham, the use of H2RA has risen 6.2-fold (from 1978 to 1983) and they were generally used intermittently in 1976-78 and later for maintenance therapy and high-dose treatment. Yet admissions for perforation and for haemorrhage were unchanged. Emergency admissions for uncomplicated DU rose by 40 per cent, from 130 in 1972-75 to 182 in 1976-84, but the proportions operated on fell markedly, from 20 to 6 per cent (P less than 0.01); waiting-list admissions fell in 1976-78 by 29 per cent and in 1979-84 by 73 per cent. The proportions operated on in the three periods fell from 74 to 53 per cent and 25 per cent respectively and these two factors led to decreases in elective surgery of 50 per cent in 1976-78 and 91 per cent in 1979-84 (P less than 0.01).(ABSTRACT TRUNCATED AT 400 WORDS)
对十二指肠溃疡（DU）的入院率以及1977年在英国特伦特地区引入的H2受体拮抗剂（H2RA）的效果进行了研究。入院率以每10⁶常住人口表示。H2RA的使用量增加了3.7倍（从1978年到1983年），然而穿孔的总体入院率变化不大：1972 - 1976年（H2RA使用前时期）为99例，而1977 - 1984年（H2RA时期）为103例。出血的入院率上升了8%，从130例升至140例（P<0.01）。然而，总体比率掩盖了65岁及以上人群入院率的大幅上升（P<0.01），穿孔入院率上升了33%（从264例升至352例），出血入院率上升了28%（从381例升至489例）。单纯性DU的急诊入院率未变：1972 - 1976年为88例，1977 - 1984年为89例。然而，接受手术的比例下降了58%（P<0.01），H2RA使用前时期手术比例为入院患者的30%，而H2RA时期仅为12%。单纯性DU的等待名单入院率下降了43%，从187例降至106例（P<0.01），接受手术的比例从162例降至76例；综合作用导致手术率降低了53%（P<0.01）。在罗瑟勒姆，H2RA的使用量增加了6.2倍（从1978年到1983年），1976 - 1978年一般为间歇性使用，后来用于维持治疗和大剂量治疗。然而，穿孔和出血的入院率未变。单纯性DU的急诊入院率上升了40%，从1972 - 1975年的130例升至1976 - 1984年的182例，但接受手术的比例显著下降，从20%降至6%（P<0.01）；1976 - 1978年等待名单入院率下降了29%，1979 - 1984年下降了73%。三个时期接受手术的比例分别从74%降至53%和25%，这两个因素导致1976 - 1978年择期手术减少了50%，1979 - 1984年减少了91%（P<0.01）。（摘要截短至400字）
