Gupta S D, Petrus L V, Gibbins F J, Dellipiani A W
Age Ageing. 1987 May;16(3):159-64. doi: 10.1093/ageing/16.3.159.
A survey of 100 consecutive endoscopies on elderly patients with suspected obstructive dysphagia is reported. Seventy-eight patients had positive findings and one to three lesions were reported in these cases. Benign stricture of the oesophagus was the commonest finding, and led to active treatment (dilation) in most cases either with Hurst bougies or Eder dilators. Fifteen patients had upper gastro-intestinal malignancy (12 oesophagus, three stomach). All of those with oesophageal carcinoma received some form of active treatment, either in the form of radiotherapy, surgery, dilation or Celestin tube insertion. Six patients with negative endoscopies had diagnoses established by other means and in 14 no cause was identified, but in four of these symptoms settled after endoscopy. The duration of dysphagia was not particularly helpful clinically. Two thirds of 'endoscopically normal' patients had short histories with dysphagia for less than 1 year, as did half of the patients with benign stricture. Most patients who were found to be malignant had experienced dysphagia for only a short time although one patient had a 4-year history! Upper gastro-intestinal endoscopy is a safe and valuable procedure in elderly patients with dysphagia and often leads to positive therapeutic intervention even in quite frail subjects.
报告了一项对100例疑似梗阻性吞咽困难老年患者进行的连续内镜检查。78例患者有阳性发现，这些病例中报告有1至3个病变。食管良性狭窄是最常见的发现，大多数情况下会采用赫斯特探条或埃德尔扩张器进行积极治疗（扩张）。15例患者患有上消化道恶性肿瘤（12例食管癌，3例胃癌）。所有食管癌患者均接受了某种形式的积极治疗，包括放疗、手术、扩张或插入塞莱斯坦管。6例内镜检查阴性的患者通过其他方法确诊，14例未查明病因，但其中4例在内镜检查后症状缓解。吞咽困难的持续时间在临床上并不是特别有帮助。三分之二“内镜检查正常”的患者吞咽困难病史较短，不到1年，良性狭窄患者中有一半也是如此。大多数被发现为恶性的患者吞咽困难时间也较短，尽管有1例患者有4年病史！上消化道内镜检查对于吞咽困难的老年患者是一种安全且有价值的检查方法，即使对于身体相当虚弱的患者，也常常能导致积极的治疗干预。
