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目的探讨老年急腹症的临床特点及诊治要点。方法回顾性分析老年急腹症216例(老年组)和中青年156例(中青年组)的临床资料,对其病情、症状、伴随疾病、实验室及辅助检查、诊断与治疗、住院时间等进行比较分析。结果老年组以腹胀、肛门停止排气和排便、腹腔积液居多(P<0.01),中青年组则以体温升高、腹部压痛、反跳痛及肌紧张多见(P<0.01);老年组伴随疾病发生率为92.1%,中青年组为29.5%,两组比较差异有统计学意义(P<0.01);老年组手术治疗161例,非手术治疗55例,治愈或好转209例,死亡7例;中青年组手术治疗149例,非手术治疗7例,均治愈出院。老年组平均住院时间(25.5±2.5)d,中青年组(16.5±1.5)d,两组比较差异有统计学意义(P<0.01)。结论老年组急腹症临床表现不典型、伴随疾病多、病情变化快,应重视各种辅助检查,及时早期诊断,合理选择个体化治疗方案,是提高老年急腹症治愈率的关键。
Objective To investigate the clinical features and diagnosis and treatment of senile acute abdomen. Methods The clinical data of 216 cases of elderly patients with acute abdomen (aged group) and 156 middle-aged and younger patients (group of middle-aged and young adults) were analyzed retrospectively. Their condition, symptoms, concomitant diseases, laboratory and auxiliary examination, diagnosis and treatment, For comparative analysis. Results The incidence of abdominal distension, anal defecation and defecation were the most common in the elderly group (P <0.01). The middle-aged and young patients were more likely to have abdominal pain, rebound tenderness and muscle tension (P <0.01) The incidence of companion disease was 92.1% in the middle-aged group and 29.5% in the middle-aged and young group. The difference between the two groups was statistically significant (P <0.01). In the elderly group, 161 cases were treated surgically, 55 cases were treated non-surgically, 209 cases were cured or improved, 7 cases; young group 149 cases of surgical treatment, non-surgical treatment of 7 cases, were cured. The average length of hospital stay in the elderly group was (25.5 ± 2.5) days, and in the young group (16.5 ± 1.5) days, there was significant difference between the two groups (P <0.01). Conclusion The clinical manifestations of acute abdomen in elderly patients are not typical, with more diseases and rapid changes in the disease, should pay attention to various auxiliary examination, timely and early diagnosis, rational choice of individualized treatment is the key to improve the cure rate of senile acute abdomen.