老年缺血性结肠炎的特点及临床表现探讨

摘要

目的：分析老年人缺血性结肠炎的特点、临床表现及预后。方法选择该院2013年1-12月43例缺血性结肠炎的老年患者作为老年组，21例60岁以下的缺血性结肠炎患者为对照组，比较两组临床表现包括症状、内镜表现、实验室主要指标及预后。结果老年组100%合并动脉硬化相关疾病，高血压、高脂血症、糖尿病的发生率均高于对照组，两种及以上基础疾病的发生数高于对照组，老年组Hb、ALB浓度低于对照组， CRP浓度高于对照组，两组比较差异有学意义（P＜0.05)。两组WBC、LDH、BPC浓度比较差异无统计学意义(P＞0.05)，2周后结肠镜复查，老年组病灶消失率为83.72%，对照组病灶消失率为90.48%，两组均无死亡病例，两组疗效比较差异无统计学意义(P＞0.05)。结论老年缺血性结肠炎临床表现不典型，当出现腹痛、腹泻、便血时及时行结肠镜检查，有利于疾病的早期诊断，减少误诊，提高患者预后。%Objective To analyze the characteristics, clinical manifestations and prognosis of ischemic colitis in the elderly. Meth-ods 43 cases of elderly patients with ischemic colitis admitted in our hospital from January, 2013 to December, 2013 were selected as the elderly group, and 21 cases of patients with ischemic colitis under 60 years old were selected as the control group. The clinical manifestations such as symptoms, endoscopic findings, laboratory main indicators and prognosis of two groups were com-pared. Results The incidences of 100%complicated by atherosclerosis-related diseases, hypertension, hyperlipidemia and diabetes of the elderly group were higher than those of the control group, the incidence of 2 or more kinds of diseases were higher than those of the control group;the concentration of Hb, ALB was less than that of the control group, while CRP concentration was high-er than that of the control group, the differences were statistically significant(P<0.05). The differences in the concentration of WBC, LDH and BPC between the two groups were not significant. The repeat colonoscopy 2 weeks later showed that the lesions disap-pearing rate of the elderly group was 83.72%, while that of the control group was 90.48%, and no death cases occurred in both groups, the difference in efficacy between the two groups was not statistically significant (P>0.05). Conclusion The clinical mani-festations of ischemic colitis in the elderly are atypical. Colonoscopy should be timely performed when the patients have the symp-toms of abdominal pain, diarrhea and hematochezia, which is conducive to the early diagnosis of the disease, reducing misdiagnosis and improving the prognosis of the patients.