老年食管裂孔疝112例临床剖析.docVIP

老年食管裂孔疝112例临床剖析 　　【摘要】 目的 对老年食管裂孔疝的临床及内镜特点进行分析，以便更好地早期诊断及治疗，减少严重并发症。方法 对112例老年食管裂孔疝患者的临床资料进行回顾性分析，并与同期诊治的80例中青年患者进行对比。结果 老年组患者临床表现和中青年组患者相似，老年组患者吞咽困难、心脏症状发生率高于中青年组（P0.05），合并冠心病、慢性支气管炎较中青年组多见（P0.05）。胃镜检查提示老年组并发食管癌、食管狭窄较中青年组多见（P0.05）。老年组患者误诊率及手术率高于中青年组（P0.05）。结论 老年食管裂孔疝患者临床表现复杂多样，容易误诊，且多见严重并发症，应常规行胃镜检查。? 　　【关键词】 食管裂孔疝； 老年患者； 临床分析?? 　　Clinical analysis of 112 cases of hiatus hernia in the elderly ZENG Li-ming ,XU Lin-zhao,ZHAO Li-juan.Jiangmen Xinhui Traditional Chinese Medical Hospital,Jiangmen 529100,China? 　　【Abstract】 Objective To study clinical characteristics and endoscope feature of hiatus hernia in the elderly patients in order to make early diagnosis and treatment.Methods Elderly hiatus hernia patients （112cases） were collected from 2006 to 2010,and their clinical manifestations were reviewed.Their clinical and endoscope feature were compared with the young patients （60 years） at the same time.Results The elderly patients had similar clinical manifestations,but dysphagia and heart symptoms was more common in the elderly than in the young patients（P0.05）.Patients complicated with coronary heart disease and chronic bronchitis were more commonly seen in the elderly than in the young patients（P0.05）.Esophagostenosis and carcinoma of esophagus were frequently found in the elderly than in young patients（P0.05）.In the elderly patients,the false diagnostic and operating ratio were higher than those in the young patients.Conclusion The clinical symptoms are not only atypical but also variable in elderly patients,severe complications are more commonly seen,endoscope is benefit.? 　　【Key words】 Esophageal hernia； Elderly patients； Clinical analysis? 　　doi：10.3969/j.issn.1674-4985.2012.03.084?? 　　 食管裂孔疝是老年人易患的一种消化系统疾病，由于老年人自身的生理特点，患病后表现出不同的临床特点。现对2006年1月~2010年12月本院收治的192例食管裂孔疝患者的临床资料进行回顾性分析，比较其中112例老年患者（≥60岁）和80例中青年患者（60岁）的一般资料、临床表现、X线钡餐造影、胃镜检查及诊治情况等特点，现报道如下。? 　　1 资料与方法? 　　1.1 一般资料 本院住院及门诊经X线钡餐造影诊断为食管裂孔疝患者192例，其中老年组112例，年龄61~83岁，平均（66.9±5.21）岁，男43例，女69例；中青年组80例，年