摘要
目的探讨不同年龄组急性肠系膜动脉闭塞患者的临床特征。方法选择2005年6月—2013年1月急诊收治的54例急性肠系膜动脉闭塞,以60岁为分组标准,分为老年组34例和非老年组20例,对两组临床特征进行回顾性分析。结果 54例初诊均有腹痛表现,但老年组呕吐比例高于非老年组(58.8%vs 30.0%,P<0.05)。老年组的中性粒细胞比例高于非老年组(0.88±0.09 vs 0.75±0.20,P<0.05);两组D-二聚体水平均明显高于正常参考值高限,且老年组水平明显高于非老年组(2.02±0.97 vs 0.81±0.22,P<0.05)。老年组手术率亦高于非老年组(70.6%vs 40.0%,P<0.05)。结论急性肠系膜动脉闭塞多以腹痛首发,无特异性,临床易误诊,老年患者尤如此,与中青年患者比较,其更易出现呕吐、中性粒细胞增高等表现,临床应引起重视。
Objective To study clinical features of acute mesenteric arterial occlusion in different age groups. Methods Clinical data of 54 patients with acute mesenterie arterial occlusion during June 2005 and January 2013 was retro- spectively analyzed. The patients were divided into group A ( n -- 34) over 60 years old, and group B ( n =20) under 60 years old. Results All the 54 patients suffered abdominal pains in the first visit. The disgorging proportion in group A was higher than that in group B (58.8% vs 30.0% , P 〈0.05). The neutrophilic granulocyte ratio in group A was higher than that in group B (0.88 ±0.09 vs 0.75± 0.20, P 〈 0.05 ). Levels of D-dimer in the two groups were all higher than the highest nor- mal value, and the level in group A was obviously higher than that in group B (2.02± 0.97 vs 0.81 ± 0.22, P 〈 0.05 ). The operability in group A was higher than that in group B (70.6% vs 40.0% , P 〈 0.05). Conclusion Abdominal pain is the first clinical manifestation of acute mesenteric arterial occlusion without specificity, so it may be misdiagnosed especially in elderly patients. Compared with the young and middle-aged patients, elderly patients tend to have disgorging and increased neutrophil level.
出处
《临床误诊误治》
2014年第3期33-35,共3页
Clinical Misdiagnosis & Mistherapy