Van Kouwen Mariëtte C A, Drenth Joost P H, Verhoeven Herman M J M, Bos Laurens P, Engels Leopold G J B
Department of Gastroenterology and Hepatology, University Medical Center St. Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Arch Gerontol Geriatr. 2003 Jul-Aug;37(1):45-50. doi: 10.1016/s0167-4943(03)00004-9.
We performed a cross sectional analysis of the feasibility and yield of upper gastrointestinal endoscopy (UGE) in a cohort of patients aged 85 years or more. The study involved 218 patients who underwent diagnostic upper gastrointestinal endoscopy in a district general hospital between 1994 and 1998. Indication, use of sedation, endoscopic findings and treatment after endoscopy were evaluated. Indications for gastroscopy were suspicious of upper gastrointestinal bleeding (UGI) bleeding (41%), anemia (15%), and presence of dyspeptic- (31%), alarm- (9%) and/or reflux symptoms (3%). Serious UGI disease (cancer, peptic ulcer, reflux oesofagitis and/or erosive gastritis/duodenitis) was detected in 97 patients (44%). With respect to clinical presentation, serious UGI disease was present in 61% with bleeding, in 57% with reflux symptoms, in 42% with alarm symptoms, in 33% with anemia and in 28% with dyspepsia. Carcinoma was detected in eight patients (3.8%), all of them were treated with supportive care. In very old people gastroscopy is generally performed on sound indications reveals serious UGI disease in almost one out of two patients, markedly influences medical treatment, and reveals low malignancy rates (3.8%). In these patients, UGE is worthwhile and should not be omitted because of age considerations.
我们对85岁及以上患者队列中上消化道内镜检查（UGE）的可行性和检出率进行了横断面分析。该研究纳入了1994年至1998年间在一家地区综合医院接受诊断性上消化道内镜检查的218例患者。对内镜检查的指征、镇静剂的使用、内镜检查结果及内镜检查后的治疗进行了评估。胃镜检查的指征包括疑似上消化道出血（UGI）（41%）、贫血（15%）、存在消化不良症状（31%）、报警症状（9%）和/或反流症状（3%）。97例患者（44%）检测到严重的UGI疾病（癌症、消化性溃疡、反流性食管炎和/或糜烂性胃炎/十二指肠炎）。就临床表现而言，出血患者中严重UGI疾病的发生率为61%，反流症状患者中为57%，报警症状患者中为42%，贫血患者中为33%，消化不良患者中为28%。8例患者（3.8%）检测到癌症，所有患者均接受了支持性治疗。在高龄人群中，胃镜检查通常在合理指征下进行，几乎每两名患者中就有一名显示出严重的UGI疾病，对医疗治疗有显著影响，且恶性肿瘤发生率较低（3.8%）。在这些患者中，UGE是值得的，不应因年龄因素而省略。
