老年消化内科急性腹痛病因及误诊剖析.docVIP

老年消化内科急性腹痛病因及误诊剖析 　　[摘要] 目的 探讨老年消化内科急性腹痛的病因以及误诊原因，从而提高诊断老年消化内科急性腹痛的诊断率。方法 我院选取了2010年6月～2014年8月期间来治疗的150例老年急性腹痛患者作为研究对象，患者入院后及时确诊腹痛病因并实施西药对症治疗，比较观察误诊情况。 结果 导致老年疾病腹痛的主要因素为胃及十二指肠炎、胆石症、胆囊炎、消化道溃疡、急性阑尾炎、急性肠胃炎、胃肠痉挛、胰腺炎；治疗误诊率为22%，被误诊的病情包括急性胃肠炎、胆囊炎、胰腺炎、急性阑尾炎等。 结论 因老年急性腹痛患者病因较多并大多伴有不同程度的基础疾病、治疗医师收集患者病史困难、治疗医师知识和经验欠缺等原因导致误诊。因此临床治疗中要对患者的疼痛特征全面分析，结合相应的检查对患者做出准确判断，从而进行对症治疗。 　　[关键词] 老年消化内科；急性腹痛；病因；误诊；全面分析 　　[中图分类号] R447 [文献标识码] B [文章编号] 1673-9701（2015）30-0055-03 　　Analysis of etiology and misdiagnosis of acute abdominal pain in elderly gastroenterology 　　ZUO Fang CHU Chuanlian WANG Changmei 　　Department of Health， Jinan Central Hospital， Jinan 250100， China 　　[Abstract] Objective To investigate the etiology and misdiagnosis cause of acute abdominal pain in elderly gastroenterology， so that to increase the diagnosis rate of acute abdominal pain in elderly gastroenterology. Methods A 150 cases of elderly patients with acute abdominal pain treated in our hospital from June 2010 to August 2014 were selected as the research subjects. After admission， the causes of abdominal pain of patients were timely diagnosed and western symptomatic treatment was implemented. The misdiagnosis situation was observed and compared. Results The main factors leading to elderly abdominal pain were stomach and duodenum inflammation， cholelithiasis， cholecystitis， peptic ulcer， acute appendicitis， acute gastroenteritis， stomach cramps， intestinal spasm and pancreatitis. The misdiagnosis rate in the treatment group was 22%， and acute abdominal pain was mainly misdiagnosed as acute gastroenteritis， cholecystitis， pancreatitis and acute appendicitis. Conclusion Many factors lead to misdiagnosis， such as many causes of acute abdominal pain in elderly patients with varying degrees of underlying disease， the difficulty of physician in collecting a history of patients， lack of knowledge and experience of physicians. Therefore， a comprehensive analysis of the patients pain characteristics is necessary in th