老年人胸骨后疼痛或不适的鉴别和应对  

The differential diagnosis and treatment strategies of chest pain or discomfort in the elderly

作　　者：王娟[1] 陈飞雪[1] 左秀丽[1] Wang Juan;Chen Feixue;Zuo Xiuli(Department of Gastroenterology,Qilu Hospital of Shandong University,Ji′nan 250012,China)

机构地区：[1]山东大学齐鲁医院消化内科,济南250012

出　　处：《中国临床保健杂志》2022年第2期153-156,共4页Chinese Journal of Clinical Healthcare

基　　金：国家重点研发计划项目(2018YFB1307700);国家自然科学基金项目(81770538)。

摘　　要：胸骨后疼痛或不适是老年患者较常出现的症状,涉及多种疾病,及时诊断、评估和治疗可以改善预后,提高患者生活质量。老年患者以胸痛就诊时,应首先排除急性冠状动脉综合征(ACS)、急性肺栓塞、主动脉夹层等危及生命的情况。同时,老年人不可忽视的非心源性胸痛(NCCP)原因包括胃食管反流病(GERD)、食管裂孔疝、食管动力障碍、嗜酸性食管炎(EoE)、功能性胸痛、心理共病等。该文将系统综述老年人胸骨后疼痛或不适的鉴别和应对策略。Chest pain or discomfort is a common symptom in elderly patients,involving a variety of diseases,timely diagnostic evaluation and treatment of the underlying disease can improve the prognosis and the quality of life.When elderly patients complain of chest pain or discomfort,they should first be ruled out life-threatening conditions such as acute coronary syndrome(ACS),acute pulmonary embolism,aortic dissection,etc.The causes of noncardiac chest pain(NCCP)that cannot be ignored in the elderly include gastroesophageal reflux disease(GERD),hiatal hernia,esophageal dysmotility,eosinophilic esophagitis(EoE),functional chest pain,psychological comorbidity,etc.The purpose of this review is to discuss the differential diagnosis and treatment of chest pain or discomfort in the elderly.

关 键 词：胸痛 胸骨 诊断 鉴别 临床方案 老年人 

分 类 号：R54[医药卫生—心血管疾病]