What has been happening to duodenal ulcer?
What has been happening to duodenal ulcer?
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十二指肠溃疡是怎么回事？
DOI：
10.1016/s0016-5085(19)32760-x
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发表时间：
1974
期刊：
影响因子：
29.4
通讯作者：
A. Mendeloff
中科院分区：
文献类型：
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作者：
A. Mendeloff
很难不相信消化系统疾病已经存在了几千年;我们可以将胃溃疡作为病理实体记录下来，至少可以追溯到16世纪，并在19世纪上半叶以正式的教科书形式出现。对于十二指肠溃疡，我们在世纪后半叶就有了病理学描述，但在欧洲和英国，这种疾病的发病率显然还不到胃溃疡的十分之一。在大西洋的这一边，十二指肠溃疡更常见; Julius Friedenwald在1912年指出，“在他的1000名消化性溃疡患者中，52%的溃疡发生在十二指肠。1904年之前，威尔和查尔斯·梅奥曾为58例穿孔性和慢性十二指肠溃疡做过手术，比莫伊尼汉勋爵在世纪的前十年向震惊的亚瑟·赫斯特展示这种”新疾病”早了几年。随着放射学技术的发展，对于没有流血的、穿孔或梗阻的患者，人们对十二指肠溃疡的诊断达成了一些标准，但可以肯定地说，直到1940年才能对特定人群中十二指肠溃疡的发病率和患病率进行真正的评估，而且只是在少数国家的少数城市。因此，我们不可能对1940年以前这种疾病发生频率的时间趋势提出合理的看法，最好不要尝试。
It is hard not to believe that peptic disorders have existed for millennia; we can document gastric ulcers as pathological entities at least as far back as the 16th century, and in formal textbook style to Cruveilhier in the first half of the 19th century. For duodenal ulcer, we have pathological descriptions in the latter half of the 19th century, but the frequency with which the disease was encountered in Europe and England certainly seems to have been less than one-tenth that of gastric ulcer. On this side of the Atlantic duodenal ulcer was recognized more frequently; Julius Friedenwald stated in 1912'that of his 1000 patients with peptic ulcer, 52% had the ulcer in the duodenum. Will and Charles Mayo2 had operated on 58 perforated and chronic duodenal ulcers before 1904, some years before Lord Moynihan was demonstrating to a startled Arthur Hurst this" new disease" in the first decade of the 20th century. With the development of radiological technique, some criteria were agreed upon for the diagnosis of this disorder in patients who had not bled, perforated, or obstructed, but it is probably safe to say that no true appraisal of the incidence and prevalence of duodenal ulcer in a defined population could have been achieved until 1940, and then only in a few cities in a few countries. It is thus impossible to construct a reasonable idea as to the time trend for the frequency of occurrence of this disease before 1940, and it is better not to try.