老年多器官功能障碍综合征患者消化系统障碍的临床特点  

Clinical characteristics of digestive system dysfunction in the elderly with multiple organ dysfunction syndrome

作　　者：尹曙明[1] 郑松柏[1] 张伟 张赣生[1] 项平[1] 王一倩[1] 于晓峰[1] 

机构地区：[1]复旦大学附属华东医院消化科,上海200040

出　　处：《中华老年多器官疾病杂志》2011年第1期36-39,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨老年多器官功能障碍综合征(MODSE)患者消化系统障碍的临床特点。方法回顾性地调查分析近5年笔者所在医院MODSE病例中具有消化系统功能障碍表现的158例患者资料,并与66例非老年MODS患者进行比较。结果 158例MODSE患者中,平均年龄(84.23±11.46)岁,男女之比2.59:1。消化系统功能障碍的发生率无性别差异(P>0.05),基础疾病累技脏器平均6.7个,感染为常见诱发因素。MODSE器官障碍序贯顺序分析发现消化器官障碍大多排在第5位(46.20%)及第4位(30.38%)。老年组胃肠功能障碍(包括胆囊)发生率高于非老年组(80.38%vs54.55%,P<0.01),而肝功能障碍发生率低于非老年组(41.14%vs46.97%,P>0.05)。老年人消化器官功能障碍起病隐匿,症状及体征不典型,易被原发疾病及其他并发症所掩盖而延误诊治。结论认识老年人消化系统功能障碍在MODSE中的临床特点,早期给予有效干预,既是抢救MODSE患者的重要一环,也有利于提高他们的存活率,为降低病死率具有重要临床意义。Objective To explore the clinical characteristics of digestive system dysfunction in multiple organ dysfunction syndrome in the elderly（MODSE）. Methods Data of 158 MODSE patients from Huadong Hospital in recent 5 years, who had the clinical manifestations of digestive system dysfunction, were retrospectively analyzed and compared with that of nonelderly MODS patients （n=66）. Results In the elderly group, the patients＇ mean age was 84.23±11.46 years; the male to female ratio was 2.59：1; there was no difference in the incidence of digestive system dysfunction between males and females（P〉0.05）; averagely, 6.7 organs were involved in the patients; infection of various organs was the main predisposing factor of MODSE; the digestive system dysfunction occupied the fifth （46.20%） or the fourth （30.38%） place by order of organ failure in the MODSE. The incidence of digestive system dysfunction was higher in elderly group than in non-elderly group （80.38% vs 54.55%, P〈0.01）. The incidence of liver dysfunction was lower in elderly group than in non-elderly group（41.14% vs 46.97%, P〉0.05）. For MODSE patients, the digestive system dysfunction was insidious, and its clinical symptoms and signs were atypical and usually covered up by the other primary diseases and complications, which may lead to delayed treatment. Conclusion To understand the clinical characteristics of digestive system dysfunction in the elderly and to give effective interventions timely at the early stage are not only important for emergency treatment of MODSE patients, but also have important clinical significance in improving the survival rate and reducing the fatality rate of MODSE patients.

关 键 词：老年人 多器官功能衰竭 消化系统 功能障碍 

分 类 号：R92[医药卫生—药学] R57