Mechanism's _ general knowledge of morbidity of gastroduodenal ulcer

Mechanism's _ general knowledge of morbidity of gastroduodenal ulcer
Gastroduodenal ulcer is an extremely common disease. Its some manifestation is the defect that the limitation lying in the stomach duodenum wall is round or oval.
Gastric ulcer and duodenal ulcer
Can affirm, the emergence of duodenal ulcer is closely linked to gastric acid hypersecretion now. Duodenal ulcer patient, its secreting amount of average basic acid and secreting amount of maximum acid, more normal people are higher than 1( 1/2) -2 times. The reason causing gastric acid to be too much is: There are many wall cells, its quantity is 2 times more than about of normal people; The nervus vagus is hyperfunction, relatively great to stimulating the sensitiveness that reflects, the experiment proves, weaker stimulus can cause duodenal ulcer and patient's more, quicker gastric acid to secrete; The stomach has arranged the airspeed, has not been entered the duodenum in the stomach by the acid gastric juice becoming reconciled in the food, damage the intersection of duodenum and the intersection of ball and mucous membrane, and stomach arrange airspeed excitement relevant with nervus vagus. It seems like this that the hypertonia of nervus vagus, so that the gastric acid secreting amount is too much, it is a main factor of forming duodenal ulcer.
Contrary to this, gastric ulcer average the intersection of gastric acid and person who secrete of patient but lower than normal people. Gastric acid how can form gastric ulcer high patient, have two main statement at present: One kind is that mucous membrane of stomach resists the force defect. Gastric ulcer is common to the chronic gastritis patient. It is reported gastric ulcer patient secrete alkaline the intersection of stomach and the intersection of sinus and area of liquid than the intersection of sophomore period and time, patient of duodenal ulcer, chronic gastritis kind to take place the position. Too much bile flows into the stomach instead, it is the main reason for chronic gastritis, also damaged, destroyed the mucous membrane directly at the same time; Combine with the factor against strength of mucous membrane of other weakening: Coat of the stomach blood supplt bad and mucus secrete insufficient and leather regeneration ability poor, etc at the mucous membrane, cause mucomembranous protective screen of the stomach to damage seriously, so that a large amount of reverse disperse of hydrogen ion, the mucous membrane bleeds, bes rotten and forms ulcer. Therefore can imagine, chronic gastritis and the gastric ulcer patient's real gastric acid secreting amount, it may not be low, may be numerous too, only the reverse disperse is entered in mucous membrane very fast on the hydrogen ion, can't measure. Another statement is that the stomach empties the delay, so that the food is deposited in the stomach. It can cause the machinery inflation of stomach sinus that the food for a long time is held up in, and sustain and contact with the mucous membrane of stomach sinus, lead to the fact gastrin and secretion of the gastric acid of the sex increase in a large amount for the moment, damage the mucous membrane and form ulcer. Therefore, no matter which kind of statement, the forming of gastric ulcer is still resulted from gastric acid function, but and the mechanism happens in duodenal ulcer it is completely different.
Have always thought about gastric ulcer and duodenal ulcer as a disease medical science. Indeed, the two undoubtedly have a lot of basic common points: Have illness coming on at first and is resulted from gastric acid function, the chronic ulcer near both sides of pylorus; Inclination apt to recur again after this kind of ulcer is difficult to heal, heal to have; Can cause massive haemorrhage, acute and punch, chronic to penetrate with complications such as pyloric stenosis,etc. in disease; Some patients need surgery to treat, and generally employ the stomach to excise the skill mostly for a time, there is better curative effect.
However, according to a large amount of research in recent years, find gastric ulcer and duodenal ulcer on every link in disease, each have its invariable characteristics, there are a series of essences that are distinguished between the two. If duodenal ulcer is easy to send age ' 20- 35 years old) Average gastric ulcer relatively ' 40- 50 years old) It is small. Duodenal ulcer concentrates on lying in a particular narrow and small position - -Ball; And gastric ulcer can happen from cardia to the extensive position of the pylorus. To get up ill spiritual nerve to be factor close duodenal ulcer, see more mood to be unstable and getting sentimental; And the gastric ulcer patient, with chronic gastritis more; " O" Type blood group, persons who last antigen, cirrhosis, hyperfunction duodenal ulcer is getting higher relatively in incidence in disease gland function by first form; The medicine ' Aspirin, cortex steroids) The ones that cause are mostly gastric ulcer; The secreting amount of gastric acid of empty stomach of duodenal ulcer, basic acid, secreting amount of maximum acid, secreting amount of peak acid are obviously higher than normal people; And the gastric acid of gastric ulcer secreting amount is similar to normal people, even is relatively low. In having illness coming on in the mechanism, it is caused more that duodenal ulcer has been the excitement of nervus vagus, gastric acid secreted; And gastric ulcer or stomach mucous membrane resists the strength defect, cause the reverse disperse of hydrogen ion or because the stomach is emptied and delayed, the food stagnates in the stomach sinus, make gastrin secrete the enhanced consequence. Gastric ulcer have cancerate perhaps, but duodenal ulcer will not be turned into cancer malicously. It has good results to stop the pain that duodenal ulcer confronts with each other sour preparation. But then curative effect is not obvious at gastric ulcer. Because the above differences of various fields, the two have different requirements and results on also therapeutic method. If duodenal ulcer cuts off the skill to the nervus vagus, it is better than gastric ulcer that the result is far, this choose whom surgical method must consider too. In a word, in sum, from different fields such as pathogenesis, clinical manifestation and treating,etc., two obviously different, can it thinks gastric ulcer and duodenal ulcer to be two different disease.
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