Sherman P M
Division of Gastroenterology, Hospital for Sick Children, Toronto, Ontario, Canada.
Gastroenterol Clin North Am. 1994 Dec;23(4):707-25.
Peptic ulcers are a relatively infrequent occurrence in children. Ulcers in the stomach and duodenum are typically secondary to systemic illnesses or drugs in young children; secondary ulcers do not recur. In contrast, duodenal ulcers in older children and adolescents have a relapsing course that is increasingly recognized to be related to coexisting, chronic, active antral gastritis and Helicobacter pylori infection. Antihelicobacter therapy not only heals duodenal ulcers, but it alters the natural history by reducing the frequency of ulcer recurrences. Not all primary duodenal or gastric ulcers in the pediatric population, however, are related to H. pylori; their cause remains unknown. Treatment for these patients requires either antacids, H2 blockers, proton pump inhibitors, or ulcer coating agents for 6-8 weeks along with long-term maintenance therapy.
消化性溃疡在儿童中相对少见。胃和十二指肠溃疡在幼儿中通常继发于全身性疾病或药物；继发性溃疡不会复发。相比之下，大龄儿童和青少年的十二指肠溃疡有复发过程，越来越多的人认识到这与并存的慢性活动性胃窦炎和幽门螺杆菌感染有关。抗幽门螺杆菌治疗不仅能治愈十二指肠溃疡，还能通过减少溃疡复发频率改变其自然病程。然而，儿科人群中并非所有原发性十二指肠或胃溃疡都与幽门螺杆菌有关；其病因尚不清楚。这些患者的治疗需要使用抗酸剂、H2受体阻滞剂、质子泵抑制剂或溃疡涂层剂治疗6 - 8周，并进行长期维持治疗。
