中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
32期
3872-3874
,共3页
腹痛%老年人%误诊
腹痛%老年人%誤診
복통%노년인%오진
Abdominal pain%Aged%Diagnosis errors
目的：探讨消化内科老年急性腹痛患者病因构成及临床特点，分析误诊原因，提高对老年急性腹痛的诊断水平。方法回顾性分析深圳市罗湖区人民医院2012-2013年消化内科诊治的76例老年急性腹痛患者（60~96岁，老年组）的临床资料，并以同期青年急性腹痛患者128例为对照（16~40岁，青年组），对比分析两组患者的腹痛病因及误诊情况。结果老年组发病24 h 内就诊率为40.8%（31/76），青年组为73.4%（94/128），差异有统计学意义（χ2=21.42，P <0.05）。两组患者均以内科腹痛为主，两组腹痛病因构成间差异无统计学意义（χ2=17.29，P<0.05）。青年组误诊率为7.8%（10/128），低于老年组的23.7%（18/76），差异有统计学意义（χ2=10.145，P <0.01）；两组均误诊为消化系统疾病。结论老年人急性腹痛的病因较多，就诊晚，极易发生误诊，消化内科医师应提高对老年急性腹痛患者临床特点的认识及对老年急性腹痛患者的诊治水平。
目的：探討消化內科老年急性腹痛患者病因構成及臨床特點，分析誤診原因，提高對老年急性腹痛的診斷水平。方法迴顧性分析深圳市囉湖區人民醫院2012-2013年消化內科診治的76例老年急性腹痛患者（60~96歲，老年組）的臨床資料，併以同期青年急性腹痛患者128例為對照（16~40歲，青年組），對比分析兩組患者的腹痛病因及誤診情況。結果老年組髮病24 h 內就診率為40.8%（31/76），青年組為73.4%（94/128），差異有統計學意義（χ2=21.42，P <0.05）。兩組患者均以內科腹痛為主，兩組腹痛病因構成間差異無統計學意義（χ2=17.29，P<0.05）。青年組誤診率為7.8%（10/128），低于老年組的23.7%（18/76），差異有統計學意義（χ2=10.145，P <0.01）；兩組均誤診為消化繫統疾病。結論老年人急性腹痛的病因較多，就診晚，極易髮生誤診，消化內科醫師應提高對老年急性腹痛患者臨床特點的認識及對老年急性腹痛患者的診治水平。
목적：탐토소화내과노년급성복통환자병인구성급림상특점，분석오진원인，제고대노년급성복통적진단수평。방법회고성분석심수시라호구인민의원2012-2013년소화내과진치적76례노년급성복통환자（60~96세，노년조）적림상자료，병이동기청년급성복통환자128례위대조（16~40세，청년조），대비분석량조환자적복통병인급오진정황。결과노년조발병24 h 내취진솔위40.8%（31/76），청년조위73.4%（94/128），차이유통계학의의（χ2=21.42，P <0.05）。량조환자균이내과복통위주，량조복통병인구성간차이무통계학의의（χ2=17.29，P<0.05）。청년조오진솔위7.8%（10/128），저우노년조적23.7%（18/76），차이유통계학의의（χ2=10.145，P <0.01）；량조균오진위소화계통질병。결론노년인급성복통적병인교다，취진만，겁역발생오진，소화내과의사응제고대노년급성복통환자림상특점적인식급대노년급성복통환자적진치수평。
Objective To explore the cause of acute abdominal pain of the elderly patients and its clinical features in the department of gastroenterology and analyze the reason of misdiagnosis so as to improve the level of clinical diagnosis of elderly people with acute abdominal pain. Methods The clinical data of 76 elderly patients(60 - 96 years,elderly group)with acute abdominal pain which were admitted in the department of gastroenterology from January 1th 2012 to December 1th 2013 were ana-lyzed retrospectively who were compared with 128 young patients(16 - 40 years,young group)with acute abdominal pain at the same time in the ward of the Luohu People's Hospital of Shenzhen City about the etiology and misdiagnosis. Results The visiting rate within 24 hours of the elderly was 40. 8% (31 / 76)and it was 73. 4% (94 / 128)of the young;the difference was signifi-cant(χ2 = 21. 42,P < 0. 05). The patients of the two groups mainly suffered internal abdominal pain and the difference was sig-nificant of etiology between the two groups(χ2 = 17. 29,P > 0. 05). The misdiagnosis rate of the elderly group(23. 7% ,18 /76)was lower than young group(7. 8% ,10 / 128)with significant difference(χ2 = 10. 145,P < 0. 01);and the acute ab-dominal pain of the patients in the two groups were both mistaken for digestive system diseases. Conclusion Because of the vari-ous etiopathogenisis and non - typical clinical manifestation,the acute abdominal pain of the elderly is easily misdiagnosed and under - diagnosed. Digestive physician should enhance the understanding of clinical features of the abdominal pain in the elderly patients and improve their diagnosis and treatment level.
