- 1、本文档共71页,可阅读全部内容。
- 2、原创力文档(book118)网站文档一经付费(服务费),不意味着购买了该文档的版权,仅供个人/单位学习、研究之用,不得用于商业用途,未经授权,严禁复制、发行、汇编、翻译或者网络传播等,侵权必究。
- 3、本站所有内容均由合作方或网友上传,本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺!文档内容仅供研究参考,付费前请自行鉴别。如您付费,意味着您自己接受本站规则且自行承担风险,本站不退款、不进行额外附加服务;查看《如何避免下载的几个坑》。如果您已付费下载过本站文档,您可以点击 这里二次下载。
- 4、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等,请点击“版权申诉”(推荐),也可以打举报电话:400-050-0827(电话支持时间:9:00-18:30)。
查看更多
Peptic Ulcer Department of Gastroenterology and Hepatology The Second Affiliated Hospital Chongqing Medical University Introduction Definition: PU is ulceration which may occur at any site in the gastrointestinal tract that is exposed to acid-pepsin secretion. (“no acid, no ulcer.”) Defects in the gastrointestinal mucosa extending through the muscularis mucosae into the submucosa or muscularis Definition Ulcer : defects in the gastrointestinal mucosa penetrate the muscularis mucosa Erosion : small superficial mucosal lesions do not penetrate the muscularis mucosa ulcer erosion Introduction Typical ulcers: Gastric ulcer (GU) , Duodenal ulcer (DU) Epidemiology Peptic ulcers (PU) occur in up to 10~15% of the population at some time, and are more common in men. In DU and GU, men : women=4.4~6.8:1 and 3.6~4.7:1 respectively. Duodenal ulcers (DU) are more common than gastric ulcers (GU). PU occur at different age. DU are about 10 times more common than GU in young patients, but in the older age groups the frequency is about equal. Introduction Two major causes: Hp (helicobacter pylori) NSAIDs (non-steroidal anti-inflammatory drugs) Aicd hypersecretory states such as Zollinger-Ellison syndrome Main mechanism: Imbalance between aggressive factors and mucosal defenses aggressive ~ defensive,repairing ~ Hp medicine(NSAIDS) gastric acid and pepsin other factors: stress,smoking,coffee, alcohol mucus(excluding pepsin) bicarbonate(neutralizing acid) mucosal barrier mucosal blood flow prostaglandins epithelial cell restitution epithelial cell replication 1.Mucus/Bicarbonate Barrier The first line of defense is mucus and bicarbonate secretion(粘液和碳酸氢盐的分泌). It stabilizes the pH between the lumen and the surface epithelial cells. Mucus gel( 粘液凝胶)in patients with H.p infection was found to be structurally weak. 2.Mucosa Barrier Th
文档评论(0)