中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
3期
161-161,163
,共2页
食管外表现%老年%胃食管反流病%误诊
食管外錶現%老年%胃食管反流病%誤診
식관외표현%노년%위식관반류병%오진
Extra esophageal manifestation%Elderly%Gastroesophageal reflux disease%Misdiagnosis
目的：探讨老年胃食管反流病(GERD)患者临床误诊原因，以避免临床出现误诊以及误治现象。方法：2012年6月-2014年6月收治老年GERD患者169例，其中误诊患者10例。对10例误诊患者的临床误诊资料实施回顾性分析。结果：所有患者临床均未表现出显著的反酸症状以及胃部灼热症状。其中咳嗽、咽部异物感以及咽痒7例，胸闷、胸痛2例，呼吸困难1例。临床误诊率5.92%(10/169)，其中临床误诊患有慢性支气管炎疾病5例，冠心病心绞痛3例，慢性咽炎1例，哮喘1例。临床误诊时间21 d～12个月。误诊后，根据患者的临床症状表现以及对患者实施胃镜检查的结果，最终有效确诊患有GERD疾病，针对患者选择奥美拉唑以及多潘立酮等药物给予临床治疗，患者的临床症状表现显著改善。结论：针对老年GERD患者，需要对其食管外表现给予密切观察，针对临床症状表现吞咽困难、气管炎以及哮喘等患者，在对其实施专科治疗后，如果临床未获得显著的治疗效果，此时判断患者患有GERD疾病，应该对患者实施胃镜检查等相关的实验室检查，有效明确患者所患疾病。
目的：探討老年胃食管反流病(GERD)患者臨床誤診原因，以避免臨床齣現誤診以及誤治現象。方法：2012年6月-2014年6月收治老年GERD患者169例，其中誤診患者10例。對10例誤診患者的臨床誤診資料實施迴顧性分析。結果：所有患者臨床均未錶現齣顯著的反痠癥狀以及胃部灼熱癥狀。其中咳嗽、嚥部異物感以及嚥癢7例，胸悶、胸痛2例，呼吸睏難1例。臨床誤診率5.92%(10/169)，其中臨床誤診患有慢性支氣管炎疾病5例，冠心病心絞痛3例，慢性嚥炎1例，哮喘1例。臨床誤診時間21 d～12箇月。誤診後，根據患者的臨床癥狀錶現以及對患者實施胃鏡檢查的結果，最終有效確診患有GERD疾病，針對患者選擇奧美拉唑以及多潘立酮等藥物給予臨床治療，患者的臨床癥狀錶現顯著改善。結論：針對老年GERD患者，需要對其食管外錶現給予密切觀察，針對臨床癥狀錶現吞嚥睏難、氣管炎以及哮喘等患者，在對其實施專科治療後，如果臨床未穫得顯著的治療效果，此時判斷患者患有GERD疾病，應該對患者實施胃鏡檢查等相關的實驗室檢查，有效明確患者所患疾病。
목적：탐토노년위식관반류병(GERD)환자림상오진원인，이피면림상출현오진이급오치현상。방법：2012년6월-2014년6월수치노년GERD환자169례，기중오진환자10례。대10례오진환자적림상오진자료실시회고성분석。결과：소유환자림상균미표현출현저적반산증상이급위부작열증상。기중해수、인부이물감이급인양7례，흉민、흉통2례，호흡곤난1례。림상오진솔5.92%(10/169)，기중림상오진환유만성지기관염질병5례，관심병심교통3례，만성인염1례，효천1례。림상오진시간21 d～12개월。오진후，근거환자적림상증상표현이급대환자실시위경검사적결과，최종유효학진환유GERD질병，침대환자선택오미랍서이급다반립동등약물급여림상치료，환자적림상증상표현현저개선。결론：침대노년GERD환자，수요대기식관외표현급여밀절관찰，침대림상증상표현탄인곤난、기관염이급효천등환자，재대기실시전과치료후，여과림상미획득현저적치료효과，차시판단환자환유GERD질병，응해대환자실시위경검사등상관적실험실검사，유효명학환자소환질병。
Objective:To explore the clinical misdiagnosis reason of elderly patients with GERD(gastroesophageal reflux disease), in order to avoid misdiagnosis and mistreatment phenomenon in clinic.Methods:169 elderly patients with GERD were selected from June 2012 to June 2014.10 patients were misdiagnosed.The clinical misdiagnosis data of 10 cases of misdiagnosed patients were retrospectively analyzed.Results:All patients showed no obvious clinical symptoms of sour regurgitation and heartburn,7 cases were cough,pharyngeal foreign body sensation and pharyngeal itching;2 cases were chest tightness and chest pain;1 case was dyspnea.The clinical misdiagnosis rate was 5.92%(10/169);5 cases were clinical misdiagnosis with chronic bronchitis disease;cases were coronary heart disease angina;1 case was chronic pharyngitis;1 case was asthma.The clinical misdiagnosis time was 21 days to 12 months.After misdiagnosis,according to the clinical symptoms of patients and the results of the implementation of gastroscopy for patients,the patients were final effective diagnosed with GERD disease.Selecting omeprazole,domperidone and other drugs for patients given clinical treatment,the clinical symptoms were significantly improved.Conclusion:For elderly patients with GERD,the extra esophageal manifestations need close observation.According to the clinical symptoms of patients with dysphagia,bronchitis and asthma,when they are given specific treatment,if the clinic not get significant treatment effect,at the moment we judge patients with GERD disease,we should give gastroscopy and related laboratory examination for patients to make effective clear patients with the disease.
