老年危重症疾病谱分析及对策：423例研究

目的：了解老年危重症疾病谱规律，为老年危重症的救治提供参考。方法回顾性分析423例老年危重症患者的临床资料。分析疾病谱构成比、发病季节、器官功能障碍及疾病转归情况；423例老年危重症病例分3个年龄亚组（≥60岁，老年组），并与同期的59例中青年危重症患者（＜60岁，对照组）进行对比，比较疾病谱构成比及预后。结果（1）循环系统疾病236例（55.8%），居各系统疾病的第1位；神经系统疾病和呼吸系统疾病占第二、三位，分别为200例（47.3%）和170例（40.2%）。（2）各年龄亚组疾病谱除呼吸系统疾病、消化系统疾病及肿瘤有明显年龄差异外，其他疾病各年龄亚组无明显差异。（3）发病有明显季节特征的为呼吸系统疾病。（4）2个和3个器官功能障碍的分别为167例（39.5%）和81例（19.1%），两者占60%。老年组发生多器官功能障碍比例显著多于对照组；以肺功能及心功能障碍居前二位；（5）各年龄亚组疾病转归差异均无统计学意义。（6）老年危重症疾病的预后好转285例（68.2%），病死率居前三位的是心脑血管疾病、呼吸系统疾病和肿瘤。结论老年危重症患者病种多、病情变化快、易诱发多器官功能衰竭，死亡率高，在慢性病防控方面要加强预防，在积极治疗原发病的同时要注意保护脏器功能，及时治疗多器官功能障碍综合征。

Spectra of critical illness in the elderly and corresponding countermeasures: analysis of 423 cases

ObjectiveToinvestigate the regular pattern of spectra ofcritical diseases in the elderlyin order to provide some referencefor further treatment.MethodsA retrospective analysiswas performed ontheclinicaldata of423elderly patients（mean age 76.79 years, ranging from 60 to 102 years） withcritical diseases admitted in Bozhou People’s Hospital from February 2011 to February 2014.The constituent ratio of disease spectra, onset seasons, organ dysfunction and prognosis were analyzed.These423 elderly patients （〉60 years old,elderly group）were divided into3subgroups according to their ages.The other 59 young and middle-aged patients（〈60 years old） were taken as controls （control group）.The diseasespectraand prognosis were comparedamong differentsubgroups.Results（1）In this cohort, circulation system disease（ESD）accounted for 55.8%（236 cases）,taking the first place among other system diseases, followed by nervous system disease（NSO,47.3%, 200 cases） and respiratory system disease（RSD,40.2%, 170 cases）. （2） There were significant differences inthe spectra of RSD and digestive system diseases（DSD）and tumors among different agesubgroups, but no suchdifference was found in other system diseases. （3） TheRSD had obvious seasonal characteristics. （4）There were 167 （39.5%） patientswith2 and 81 patients （19.1%）with3 dysfunctioned organs, totally accounting for60%. The ratio of multipleorgan dysfunction was significantly higher in the elderly group thaninthecontrol one. Lungs and heart dysfunction ranked the firsttoptwo places.（5）There was no significant difference in the prognosis among the different agesubgroups.（6）A total of 285 senile patients （68.2%） got betterprognosis. Mortality of the topthree wascardio-cerebrovascular diseases, respiratory system disease, and cancer in this study.Conclusion Critical illness in the elderlyis characterizedwith complicateddiseasespectra, quickly changed condition, multiple organ failure, and high mortality. Therefore, w