CAJ | 학술논문

目的：了解老年危重症疾病谱规律，为老年危重症的救治提供参考。方法回顾性分析423例老年危重症患者的临床资料。分析疾病谱构成比、发病季节、器官功能障碍及疾病转归情况；423例老年危重症病例分3个年龄亚组（≥60岁，老年组），并与同期的59例中青年危重症患者（＜60岁，对照组）进行对比，比较疾病谱构成比及预后。结果（1）循环系统疾病236例（55.8%），居各系统疾病的第1位；神经系统疾病和呼吸系统疾病占第二、三位，分别为200例（47.3%）和170例（40.2%）。（2）各年龄亚组疾病谱除呼吸系统疾病、消化系统疾病及肿瘤有明显年龄差异外，其他疾病各年龄亚组无明显差异。（3）发病有明显季节特征的为呼吸系统疾病。（4）2个和3个器官功能障碍的分别为167例（39.5%）和81例（19.1%），两者占60%。老年组发生多器官功能障碍比例显著多于对照组；以肺功能及心功能障碍居前二位；（5）各年龄亚组疾病转归差异均无统计学意义。（6）老年危重症疾病的预后好转285例（68.2%），病死率居前三位的是心脑血管疾病、呼吸系统疾病和肿瘤。结论老年危重症患者病种多、病情变化快、易诱发多器官功能衰竭，死亡率高，在慢性病防控方面要加强预防，在积极治疗原发病的同时要注意保护脏器功能，及时治疗多器官功能障碍综合征。
목적：료해노년위중증질병보규률，위노년위중증적구치제공삼고。방법회고성분석423례노년위중증환자적림상자료。분석질병보구성비、발병계절、기관공능장애급질병전귀정황；423례노년위중증병례분3개년령아조（≥60세，노년조），병여동기적59례중청년위중증환자（＜60세，대조조）진행대비，비교질병보구성비급예후。결과（1）순배계통질병236례（55.8%），거각계통질병적제1위；신경계통질병화호흡계통질병점제이、삼위，분별위200례（47.3%）화170례（40.2%）。（2）각년령아조질병보제호흡계통질병、소화계통질병급종류유명현년령차이외，기타질병각년령아조무명현차이。（3）발병유명현계절특정적위호흡계통질병。（4）2개화3개기관공능장애적분별위167례（39.5%）화81례（19.1%），량자점60%。노년조발생다기관공능장애비례현저다우대조조；이폐공능급심공능장애거전이위；（5）각년령아조질병전귀차이균무통계학의의。（6）노년위중증질병적예후호전285례（68.2%），병사솔거전삼위적시심뇌혈관질병、호흡계통질병화종류。결론노년위중증환자병충다、병정변화쾌、역유발다기관공능쇠갈，사망솔고，재만성병방공방면요가강예방，재적겁치료원발병적동시요주의보호장기공능，급시치료다기관공능장애종합정。
ObjectiveToinvestigate the regular pattern of spectra ofcritical diseases in the elderlyin order to provide some referencefor further treatment.MethodsA retrospective analysiswas performed ontheclinicaldata of423elderly patients(mean age 76.79 years, ranging from 60 to 102 years) withcritical diseases admitted in Bozhou People’s Hospital from February 2011 to February 2014.The constituent ratio of disease spectra, onset seasons, organ dysfunction and prognosis were analyzed.These423 elderly patients (>60 years old,elderly group)were divided into3subgroups according to their ages.The other 59 young and middle-aged patients(<60 years old) were taken as controls (control group).The diseasespectraand prognosis were comparedamong differentsubgroups.Results(1)In this cohort, circulation system disease(ESD)accounted for 55.8%(236 cases),taking the first place among other system diseases, followed by nervous system disease(NSO,47.3%, 200 cases) and respiratory system disease(RSD,40.2%, 170 cases). (2) There were significant differences inthe spectra ofRSDand digestive system diseases(DSD)and tumors among different agesubgroups, but no suchdifference was found in other system diseases. (3) TheRSD had obvious seasonal characteristics. (4)There were 167 (39.5%) patientswith2 and 81 patients (19.1%)with3 dysfunctioned organs, totally accounting for60%. The ratio of multipleorgan dysfunction was significantly higher in the elderly group thaninthecontrol one. Lungs and heart dysfunction ranked the firsttoptwo places.(5)There was no significant difference in the prognosis among the different agesubgroups.(6)A total of 285 senile patients (68.2%) got betterprognosis. Mortality of the topthree wascardio-cerebrovascular diseases, respiratory system disease, and cancer in this study.Conclusion Critical illness in the elderlyis characterizedwith complicateddiseasespectra, quickly changed condition, multiple organ failure, and high mortality. Therefore, we should strengthen theunderlying diseases and control of chronic diseases, actively treat the primarydiseaseandpay attention to the protection of organ function at the same time, and timelymanage organ dysfunction syndrome.