急诊中心老年输尿管结石患者的诊断特点

Hyun Suk Sim, H. S. Choi, J. S. Lee, H. Hong, Y. Ko
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引用次数: 0

摘要

背景:输尿管结石的发病率在全球范围内普遍呈上升趋势,尤其是65岁以上的老年人。因此,我们对急诊中心诊断为输尿管结石的老年患者的特征进行了研究。方法:回顾性分析2012年1月至2014年3月连续613例经计算机断层扫描诊断为输尿管结石的患者。患者分为两组:老年组和非老年组。结果:613例患者中,老年患者64例(≥65岁,占10.4%),非老年患者549例(<65岁,占89.6%)。老年患者中有13例(20.3%)无疼痛或不典型疼痛,非老年患者中有39例(7.1%)无疼痛或不典型疼痛,差异有统计学意义(p<0.001)。恶心和呕吐等胃肠道症状在老年患者中比在非老年患者中更常见(42.2%比29.9%,p=0.044),而显微镜下血尿的阳性率较低(78.1%比90.5%,p=0.002)。老年患者肋椎角压痛阳性率较低,输尿管远端结石较多,尿pH值和血清肌酐水平较高。结论:与非老年患者相比,老年输尿管结石患者肾绞痛和血尿发生率较低,而恶心、呕吐等胃肠道症状发生率较高。因此,在评估老年患者时应考虑两组之间的差异,以防止因输尿管结石的晚期诊断而引起的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic Characteristics of Geriatric Patients With Ureterolithiasis in Emergency Center
Background: Incidence rate of ureterolithiasis has been increasing worldwide in general, with an especially rapid increase in the elderly, over 65 years of age. Therefore, the characteristics of geriatric patients diagnosed with uureterolithiasis in an Emer- gency Center were examined. Methods: A total of 613 consecutive patients who were diagnosed with ureterolithiasis through computed tomography from January 2012 to March 2014 were analyzed retrospectively. The patients were divided in two groups: the geriatric group and nongeriatric group. Results: Among the 613 patients, there were 64 geriatric patients (≥65 years, 10.4%) and 549 nongeriatric patients (<65 years, 89.6%). In the geriatric patients, 13 patients (20.3%) appeared without any pain or with atypical types of pain, while 39 of the nongeriatric patients (7.1%) had no pain or atypical symptoms, presenting a statistically significant difference (p<0.001). Gastrointestinal symptoms such as nausea and vomiting were more common in geriatric patients than in nongeriatric patients (42.2% vs. 29.9%, p=0.044), while lower positive rate of microscopic hematuria was reported (78.1% vs. 90.5%, p=0.002). Furthermore, in geriatric patients, the positive rate of costovertebral angle tenderness was lower and distal ureter stones were found to be more common, while urine pH and serum creatinine levels were higher. Conclusion: In comparison to nongeriatric patients, geriatric patients with ureterolithiasis showed lower rates of renal colic and hematuria, while showing higher rates of having gastrointestinal symptoms such as nausea and vomiting. Thus, diffe- rences between these two groups should be considered in evaluating geriatric patients to prevent complications which may be caused from the late diagnosis of ureterolithiasis.
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