172例老年人急性肠梗阻的病因及其治疗  

Etiology and treatment of acute intestinal obstruction in elderly patients： analysis of 172 cases

作　　者：瞿彩兴[1] 许志云[1] 

机构地区：[1]镇江市第一人民医院,江苏镇江212002

出　　处：《现代保健（医学创新研究）》2008年第9期12-13,共2页

摘　　要：目的分析老年人肠梗阻的发病原因及手术时机的选择。方法回顾性分析住院治疗的172例肠梗阻的临床资料。结果病因中肿瘤68例，占40．1％，肠粘连29例，占16．9％，嵌顿疝19例，占11％，粪石性梗阻18例，占10．4％，炎症性粘连17例，占9．8％，肠系膜血管栓塞10例，占5．8％，肠扭转11例，占6．3％。手术治疗的120例中，肠肿瘤和肠粘连所致的急性肠梗阻为主要原因。术后并发症25例，占21％，死亡5例，占4．1％。结论（1）老年人急性肠梗阻的主要原因为肿瘤，少见原因如粪石性梗阻、肠系膜血管栓塞、腹腔内急性炎症性粘连及肠扭转等所占比例有上升趋势。（2）加强围手术期处理可减少术后死亡率。（3）合理选择手术时机及手术方式是保证治疗成功、改善患者术后生活质量的关键。Objective To investigate the etiology and treatment of acute intestinal obstruction in elderly patients. Methods The clinical data of 172 cases of acute intestinal obstruction admitted in our department were analyzed. Results Of 172 cases, Neoplasm, adhesion were the most common causes, which accounted for 40. 1% （68/172）, 16. 9% （29/172）. Others were incarcerate hernia, feculent mass obstruction, inflammatory conglutination, mesentery embolism and volvulus which accounted for 11% （ 19/172 ）, 10.4% （ 18/172 ）, 9. 8% （ 17/172 ）, 5.8 % （10/172） and 6.3% （11/172） respectively. Among 120 patients who underwent operation, Neoplasm and adhesion were the main causes. Complications after operation occurred in 25 cases which occurred for 21%. 5 cases were died, with the mortality being 4. 1%. Conclusion （ 1 ） Neoplasm is the most common causes of acute intestinal obstruction in elderly patients. Others, for examples, adhesion, incarcerate hernia, feculent mass obstruction, inflammatory conglutination, mesentery embolism and volvulus have the trend to increase. （2）Intensive perioperative management can decrease the mortality. （ 3 ） Appropriate surgical time selection and surgical modality are crucial to ensure the successful of operation and improve the quality of life after operation.

关 键 词：肠梗阻 老年 病因分析 手术时机 

分 类 号：R574.2[医药卫生—消化系统]