不同年龄食管裂孔疝相关危险因素和常见误诊疾病分析

目的分析不同年龄食管裂孔疝的相关危险因素，并对其常见误诊疾病进行分析。 方法回顾性分析2012年7月至2016年12月新疆维吾尔自治区人民医院收治的食管裂孔疝患者168例，其中92例<60岁（中青年组），76例≥60岁（老年组）。采用多因素Logistic回归分析筛选不同年龄段食管裂孔疝相关危险因素。同时采用χ²检验比较中青年组与老年组食管裂孔疝患者常见误诊疾病比例差异。 结果体重指数、进食过饱、睡前进食是中青年食管裂孔疝的独立危险因素（P=0.013、0.030、0.015）；睡前进食、习惯性便秘、慢性咳嗽是老年食管裂孔疝的独立危险因素（P=0.024、0.018、0.039）。中青年组和老年组食管裂孔疝患者误诊为冠状动脉粥样硬化性心脏病的比例最高［21.7% （20/92）、28.9 （22/76）］，但两者差异无统计学意义；中青年组食管裂孔疝患者误诊为咽喉炎、支气管哮喘的比例高于老年组患者［19.6% （18/92）vs 9.2% （7/76）、13.0% （12/92）vs 6.6% （5/76）］，老年组食管裂孔疝患者误诊为慢性支气管炎的比例高于中青年组患者［10.9% （10/92）vs 21.1% （17/76）］，且差异均有统计学意义（χ²=10.332，P=0.001；χ²=7.911，P=0.005；χ²=9.614，P= 0.002）。 结论不同年龄食管裂孔疝的危险因素不同，常见误诊疾病也有差异，要根据年龄进行针对性防治，同时减少食管裂孔疝的误诊。

Analysis of risk factors and common misdiagnosed diseases between different age groups of hiatal hernia patients

ObjectiveTo analyze the risk factors and common misdiagnosed diseases between different age groups of hiatal hernia patients. MethodsTo retrospectively analyse 168 patients of hiatal hernia who were made a diagnosis and given treatment at Xinjiang Uygur Autonomous Region People's Hospital from July 2012 to December 2016, including 92 patients <60 years old (young and middle-aged group) and 76 patients ≥60 years old (old-aged group). Logistic regression analysis was used to analyse the risk factors between different age groups. And χ² tset was used to compare the common misdiagnosed diseases between the two goups. ResultsHigh body mass index (BMI), eating too much, and eating before sleeping were the independent risk factors of young and middle-aged patients with hiatal hernia (P=0.013, 0.030, 0.015), and eating before sleeping, habitual constipation and chronic coughing were the independent risk factors of old-aged patients (P=0.024, 0.018, 0.039). The rate of misdiagnosis of hiatal hernia as coronary heart disease was highest in young and middle-aged group and old-aged group [21.7%(20/92), 28.9 (22 / 76)], but there was no difference in the two groups. The rates of misdiagnosis of hiatal hernia as laryngitis, bronchial asthma in young and middle-aged group were higher than that of old-aged group [19.6% (18/92) vs 9.2%(7/76), 13.0%(12/92) vs 6.6%(5/76)], and the rate of misdiagnosis of hiatal hernia as chronic bronchitis in old-aged group was higher than that of young and middle-aged group [10.9%(10/92) vs 21.1%(17/76)], the differences were statistically significant (χ²=10.332, P=0.001; χ²=7.911, P=0.005; χ²=9.614, P=0.002). ConclusionsThere were different risk factors and common misdiagnosed diseases between different age groups of hiatal hernia patients. Targeted prevention and treatment of hiatal hernia patients should be carried accoding to age, and the misdiagnosis of hiatal hernia patients could be reduced.