成人不同年龄段外科急腹症的疾病谱分析  

The analysis on acute surgical abdominal disease spectrum in different ages of adults

作　　者：杨欣[1] 李能平[1] 卢小兵[1] 

机构地区：[1]上海市浦东新区公利医院急诊外科,200135

出　　处：《临床外科杂志》2009年第5期328-330,共3页Journal of Clinical Surgery

摘　　要：目的探讨成人不同年龄段外科急腹症疾病谱特点，以提高对外科急腹症的诊治水平。方法分析2004年1月至2005年1月在我院急诊外科就诊的1342例外科急腹症患者临床资料，根据年龄分为青壮年组（18～40岁）、中年组（41-60岁）、老年组（〉60岁），分析成人不同年龄段外科急腹症的疾病谱及误诊、死亡情况。结果青壮年组554例，急性阑尾炎最多见，占79．4％（440／554），共误诊9例，占1．6％；死亡1例，占0．2％。中年组415例，胆道疾病最多见，占33．0％（137／415），共误诊15例，占3．6％；死亡3例，占0．7％。老年组373例，胆道疾病最多见，占50．9％（190／373），共误诊20例，占5．4％；死亡30例，占8．0％。老年组误诊率及病死率较其他两组明显增高，P〈0．05。结论不同年龄段外科急腹症疾病谱不同，随着年龄的增加，有生命危险的急腹症逐渐增加，误诊率、病死率显著增高，外科急诊医师应高度警惕和重视。Objective To explore the characteristics of acute surgical abdominal disease spectrum in different ages of adults. Methods The clinical data of 1342 patients with acute surgical abdomen were retrospectively analyzed from January 2004 to January 2005 at the emergency department. All cases were divided into 3 groups：young group （18 -40 years old） ,middle age group （41-60 years old） and elderly group （ 〉 60 years old）. Surgical abdominal disease spectrum, misdiagnosis and mortality were analyzed in different ages of adults. Results The most common cause of the young patients was acute appendicitis （440/554） , accounting for 79.4% ,9 patients were misdiagnosed, accounting for 1.6% , and one died, accounting for 0.2%. The most common cause of the middle age patients was biliary disease （ 137/415）, accounting for 33%, 15 patients were misdiagnosed, accounting for 3.6%, and 3 died, accounting for 0.7%. The most common cause of the elderly patients was biliary disease （ 190/373 ）, accounting for 50.9% , 20 patients were misdiagnosed, accounting for 5.4% , and 30 died, accounting for 8%. The misdiagnosis rate and mortality among elderly group were significantly higher than other groups ,P 〈 0.05. Conclusion The acute surgical abdominal disease spectrum in different ages varied. With aging, the incidence of acute abdominal diseases threatening the life will be gradually increased, and the rate of misdiagnosis and mortality increased significantly.

关 键 词：外科急腹症 年龄 疾病谱 

分 类 号：R656.1[医药卫生—急诊医学]