80岁以上患者外科急腹症的诊治特点

目的分析≥80岁外科急腹症住院患者的诊治特点。方法将2002年1月1日至2009年12月31日外科急腹症入院治疗的5426例患者按年龄分为≥80岁组和〈80岁组。观察≥80岁急腹症患者人数、所占比例、病种分布、伴发疾病等特点；统计分析手术比率、治疗效果、病死率、住院时间和住院花费。结果我院8年来纳入患者5426例，≥80岁患者420例，数量和所占百分比总体呈逐年增加趋势。患者从症状发作到就诊时间差2h至21d不等。常伴发多种疾病，以呼吸和心血管系统疾病居多。≥80岁组与〈80岁组比较，急诊手术率下降（48．09％比64．19％，P〈0．01），病死率增加（3．33％比1．38％，P〈0．01），住院时间延长[（16．76±11．49）d比（14．50±16．08）d，P〈0．01）]，人均住院花费增加[（23733．11±30571．75）元比（18530．83±29637．46）元，P〈0．01）]。结论根据t〉80岁患者的发病特点制定个体化诊治方案；在制定卫生经济学政策和医疗保险制度时，注意考虑年龄对住院患者病死率、住院时间和治疗费用的影响。

Characteristics in elderly patients over 80 years old with acute abdomen

Objective To evaluate the characteristics of diagnosis and treatment in elderly patients over 80 years old with acute abdomen.Methods 5426 elderly patients with acute abdomen were enrolled from January 1,2002 to December 31,2009 in our hospital and were divided into two groups according age: one group with patients≥80 years old(420 cases) and another group <80 years old(5006 cases).Data were analyzed include operability rate,mortality,lenght of stay and admission fee.Results More and more aged patients were treated in hospital.They went to hospital in from 2 h to 21 d after unfitness.They often have several complications including respiratory,cardiovascular system diseases.Compared with<80 group,operability rate was lower(48.09% vs 64.19%,P<0.01),mortality was higher(3.33% vs 1.38%,P<0.01),mean hospital length of stay was longer(16.76±11.49 d vs 14.50±16.08 d,P<0.01),admission fee was more significantly increased(RMB 23 733.11±30 571.75 vs 18 530.83±29 637.46,P<0.01)in group≥80.Conclusions Characteristic of elderly patients should be payed attention to in favor of increasing efficiency in diagnosis and treatment and making medical policy.