90岁以上高龄老年人胃镜检查结果分析  

Analysis of gastroscopic characteristics in elderly people aged over 90 years

作　　者：吴曦[1] 许乐[1] 

机构地区：[1]卫生部北京医院消化内科,100730

出　　处：《中华老年医学杂志》2013年第12期1300-1302,共3页Chinese Journal of Geriatrics

摘　　要：目的了解高龄老年人（≥90岁）上消化道疾病的发病特点及进行胃镜检查的必要性及安全性。方法对50例行胃镜检查高龄老年人的临床资料进行回顾性分析。结果上消化道疾病的总体检出率为76．0％（38／50），其中反流性食管炎（RE）最为常见，占26．0％；余依次为糜烂性胃炎20．0％、萎缩性胃炎18．0％、消化性溃疡12．0％、消化道恶性肿瘤10．0％、十二指肠球炎8．0％及胃底腺息肉6．0％。检出RE病变以轻型为主，根据内镜下洛杉矶分级标准分级LA—A级46．1％、LA—B级30．8％、LA—c级7．7％、LA-D级15．4％。受检者最常见的临床症状为腹胀及食欲减退，发生率均为12．0％。胃镜检查有器质性疾病者与无异常发现者临床症状发生率分别为44．7％（17／38）比41．7％（5／12），差异无统计学意义（X=0．035，P=0．852）。静脉麻醉下胃镜检查率为44．0％。结论高龄老年人上消化道疾病发病率高，以RE最多见，病变程度以轻型为主；高龄老年人临床症状较少或不典型；静脉麻醉下胃镜检查对于高龄老年人具有较高的安全性及可行性。Objective To investigate the clinical characteristics of upper gastrointestinal diseases in very old people （aged ~ 90 years）, and to explore the necessity and safety of the gastroscopy for the super elderly people. Methods Clinical data of 50 very old people were retrospectively analyzed. Results The total detection rate of upper gastrointestinal disease was 76.0% （38/50）, in which the reflux esophagitis （RE） was the most common （26.0%）, followed by erosive gastritis （20.0 ~ ）, atrophic gastritis （18.0 % ）, peptic ulcer （ 12.0 ~/0 ）, gastrointestinal cancer （10.0%）, duodenitis （8.0~） and fundic gland polyps （6.0%） respectively. RE lesions detected by gastroscopy were mainly mild and were divided into endoscopic grade LA-A （46.1%）, LA-B （30.8%）, LA-C （7.7%）, and LA-D （15.4%） according to the Los Angeles classification. The most common symptoms were abdominal distension and anorexia, and the both incidences were 12.0%. There was no significant difference in the prevalence of clinical symptoms between the elderly people with upper gastrointestinal disease and without abnormal gastroscopic findings C44.7~~ （17/38） vs. 41.7% （5/12）, Z2 --0.035, P^0.05~. 22 patients （44.0%） underwent gastroscopy under intravenous anesthesia. Conclusions The incidence of upper gastrointestinal disease is high in very old people, and mild reflux esophagitis is the most common. Clinical symptoms are little or asymptomatic in most very old people. Gastroscopy under intravenous anesthesia is safe and feasible for the very old people.

关 键 词：老年人 90岁及以上 胃镜检查 反流性食管炎 

分 类 号：R573[医药卫生—消化系统]