Gustavsson S, Kelly K A, Melton L J, Zinsmeister A R
Department of Surgery, Mayo Clinic and Foundation, Rochester, Minnesota.
Gastroenterology. 1988 Mar;94(3):688-94. doi: 10.1016/0016-5085(88)90240-5.
We evaluated trends in peptic ulcer surgery among residents of Rochester, Minnesota, where medical care delivered to the population by all providers is well documented. The incidence of elective operations on previously unoperated patients declined dramatically during the 30-yr study period, from 49/100,000 population per year in 1956-1960 to 6/100,000 per year in 1981-1985. The decline was greatest for men with duodenal ulcer, less for men and women with gastric ulcer, and least for women with duodenal ulcer. These trends were established long before the introduction of H2-receptor drug therapy in 1977. In contrast to elective operations, the incidence of emergent operations remained at about 10/100,000 population per year. Perhaps because of an increasing proportion of emergency operations, overall survival appeared to worsen from the first decade of study to the last; but, after adjustment for age at operation and sex, no difference in survival over time was detected.
我们评估了明尼苏达州罗切斯特市居民的消化性溃疡手术趋势，该市所有医疗服务提供者为居民提供的医疗服务都有详细记录。在30年的研究期间，以前未接受过手术的患者进行择期手术的发生率急剧下降，从1956 - 1960年的每年49/10万人口降至1981 - 1985年的每年6/10万人口。十二指肠溃疡男性的下降幅度最大，胃溃疡男性和女性的下降幅度较小，十二指肠溃疡女性的下降幅度最小。这些趋势早在1977年引入H2受体药物治疗之前就已确立。与择期手术相反，急诊手术的发生率保持在每年约10/10万人口。可能由于急诊手术比例增加，从研究的第一个十年到最后一个十年，总体生存率似乎有所恶化；但是，在对手术时年龄和性别进行调整后，未发现随时间推移生存率存在差异。
