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目的探讨老年急性肠梗阻的临床特点及其治疗,以寻找降低死亡率的有效方法。方法回顾性总结分析128例经手术证实的60岁以上的急性肠梗阻患者的病因、临床特点及其治疗方法。结果引起肠梗阻的病因中,肿瘤64例(50.0%),肠粘连30例(23.4%),肠扭转6例(4.7%),粪块堵塞5例(3.9%),腹外疝5例(3.9%),麻痹性肠梗阻4例(3.1%),肠系膜血管疾患2例(1.6%),其他原因导致梗阻12例(9.4%)。绞窄性肠梗阻28例(21.9%),术后有并发症32例(25%),死亡7例(5.5%)。结论肿瘤是高龄急性肠梗阻的主要病因,这群病人合并基础病变多,加强围手术期处理尤其重要,早期诊断及手术可有效减低术后死亡率。
Objective To investigate the clinical features and treatment of senile acute intestinal obstruction in order to find an effective way to reduce mortality. Methods We retrospectively analyzed the etiology, clinical features and treatment of 128 patients with acute intestinal obstruction over the age of 60 confirmed by surgery. Results The causes of intestinal obstruction included 64 cases (50.0%) of tumors, 30 cases of intestinal adhesion (23.4%), 6 cases of intestinal torsion (4.7%), 5 cases of fecal blockage (3.9% 3.9%), paralytic ileus in 4 cases (3.1%), mesenteric vascular disease in 2 cases (1.6%), and other causes of obstruction in 12 cases (9.4%). Strangulated intestinal obstruction in 28 cases (21.9%), postoperative complications in 32 cases (25%), death in 7 cases (5.5%). Conclusion Tumor is the major cause of acute intestinal obstruction in elderly patients. It is especially important to strengthen perioperative management in these patients. Early diagnosis and operation can effectively reduce the postoperative mortality.