Last reviewed: 24 Mar 2025
Last updated: 10 Sep 2020
Summary
Definition
History and exam
Key diagnostic factors
- 腹痛
- 指点征
Full details
Other diagnostic factors
- 上腹部压痛
- 恶心或呕吐
- 早饱感
- 体重减轻或厌食
- 腹泻
- 贫血的症状
- 消化道出血
- 低血压性或脓毒性休克
- 振水音
Full details
Risk factors
- 幽门螺杆菌感染
- 使用非甾体抗炎药 (NSAID)
- 吸烟
- 年龄较大
- 消化性溃疡病患者的个人史
- 消化性溃疡病患者的家族史
- 重症监护病房患者
Full details
Diagnostic tests
1st tests to order
- 幽门螺杆菌尿素呼气试验或粪便抗原检测
- 上消化道内镜检查
- 全血细胞计数（FBC）
Full details
Tests to consider
- 空腹血清胃泌素水平
Full details
Treatment algorithm
ACUTE
活动性出血性溃疡
非活动性出血：幽门螺杆菌阴性
非活动性出血：幽门螺杆菌阳性
ONGOING
反复发作、面积大或难治性溃疡
抑酸治疗效果较差的 NSAID 相关性溃疡。
Contributors
Authors
Kristle Lee Lynch, MD
Assistant Professor of Clinical Medicine
Division of Gastroenterology
Department of Medicine
Hospital of the University of Pennsylvania
University of Pennsylvania
Perelman School of Medicine
Philadelphia
PA
Disclosures
KLL declares that she has no competing interests.
Acknowledgements
Dr Kristle Lynch would like to gratefully acknowledge Dr Marty M Meyer and Dr Steven Moss, previous contributors to this topic.
Disclosures
SM is on the speaker's bureau for Otsuka, the manufacturer of Helicobacter pylori breath-test kits. MMM declares that he has no competing interests.
Peer reviewers
Lise Lotte Gluud, MD
Consultant
Gastrounit Medical Division
Copenhagen University Hospital Hvidovre
Copenhagen
Denmark
Disclosures
LLG declares that she has no competing interests.
Differentials
- 食管癌
- 胃癌
- 胃食管反流病 (GORD)
More DifferentialsGuidelines
- 存在幽门螺杆菌的消化不良：检查和治疗
- CDC 国际旅行健康信息（黄皮书）：幽门螺杆菌
More GuidelinesPatient information
Peptic ulcers
More Patient information
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