48例老年溃疡性结肠炎分析

目的:回顾分析老年人群(≥60岁)溃疡性结肠炎的临床特点。方法:选取榆林市第一医院2000年5月～2007年5月确诊为溃疡性结肠炎的住院患者共284例,对其临床特点进行观察,比较老年溃疡性结肠炎患者(≥60岁)与非老年溃疡性结肠炎患者(20～59岁)间是否存在差异。结果:284例溃疡性结肠炎患者中,≥60岁者48例(16.9%)。在老年溃疡性结肠炎患者中,腹痛、黏液脓血便、单纯血便、黏液便、便秘、发热、腹胀、贫血、肠外表现、并发症和癌变的发生率与非老年患者均无显著性差异(P>0.05);腹泻的发生率低于非老年患者(P<0.05),而腹泻与便秘交替则高于非老年组(P<0.05)。老年组病变位于直肠者明显少于非老年组(P<0.01),病变为广泛性在老年组则明显多于非老年组(P<0.01)。结论:老年溃疡性结肠炎临床表现及病情程度与非老年组无明显差异,腹泻与便秘交替较多见,病变部位广泛性较非老年组为多。

Objective： To retrospective analyze the clinical features of elderly patients with ulcerative colitis. Methods ： 284 cases with diagnosed ulcerative colitis in the first Hospital of Yulin city from 2000 to 2007 were recruited. The clinical features were observed and compared between the elderly （≥60 yrs） and the young （20-59 yrs） patients. Results： Among the 284 cases of ulcerative colitis, 48（16.9%） were elder. There were no significant differences in the incidence of celialgia, mucous and bloody purulent stools, simple bloody stools, mucous stools, constipation, fever, abdominal distention, anemia, extraintestinal manifestations, complications and canceration between two groups （P〉0.05）, diarrhea were less common and diarrhea-constipation alternately were. more common in the elderly group than that in young group（P〈0.05）. Compared with the young group, the lesions were less located at the rectum （P〈0.01） and were more located wide- spread （P〈0.01） in the elderly group. Conclusion： There were no significant differences in the clinical manifestation and the disease degree of ulcerative colitis between elderly and young patients, the symptom of diarrhea-constipation alternately were more common and the lesions were more located widespread in the elderly pa- tients, this might be associated with gastro- intestinal tract dysfunction, immunity and environmental factor. Coloscopy combined with biopsy was the most dependable diagnostic method for the elderly patients with ulcerative colitis.