手术治疗47例老年急性肠梗阻患者疗效分析  

The treatment experiences of senile patients with acute intestinal obstruction

作　　者：王文杰[1,2] 陆孝道[1,2] 高钢龙[1,2] 单远洲[1,2] 张学利[1,2] 

机构地区：[1]上海市奉贤区中心医院 [2]上海交通大学附属第六人民医院奉贤分院,上海奉贤201400

出　　处：《西部医学》2011年第4期677-678,681,共3页Medical Journal of West China

摘　　要：目的探讨手术治疗老年急性肠梗阻患者的临床疗效。方法回顾性分析经过手术治疗的47例老年急性肠梗阻患者的临床资料。结果 47例患者中结、直肠肿瘤21例,肠粘连12例,腹内、外疝嵌顿7例,肠扭转、粪石嵌顿各2例,肠套叠、憩室炎、坏死性降结肠炎各1例。术后并发症10例,发生率21.28%;围手术期死亡2例,死亡率4.26%。结论对无手术史且排除疝嵌顿的肠梗阻首先考虑肿瘤可能。完善病史和仔细体检、腹部立卧位摄片和腹部CT检查是提高诊断水平的常规措施。老年急性肠梗阻病情复杂,伴发疾病多,体质差,应正确掌握手术适应证、及时把握手术时机、根据患者具体情况选择合理的手术方式,有利于提高治愈率,降低死亡率。Objective To explore the diagnosis and treatment of senile patients with acute intestinal obstruction.MethodsThe data of 47 senile patients performed operation with acute intestinal obstruction were analyzed retrospectively.ResultsThe reason of obstruction concluded tumors of colon and rectum（21 cases）,intestinal adhesion（12 cases）,incarcerated hernia（7 cases）,twisted intestine（2 cases）,fecalith incarceration（2 cases）,intestinal intussusceptions（1 case）,diverticulitis（1 case） and necrotizing descending colonitis（1 case）.Complications occurred in ten patients after operation（21.28%）.2 patients died（4.26%）.ConclusionTumors should be considered firstly when the patients without operation history are excluded incarcerated hernia.Consummating the medical history,careful physical examination,erect and supine position films and ventral CT examination are routine measures.Because of the complicated conditions of senile patients with intestinal obstruction,numerous comorbidities and weak constitution,we should master correctly the indiction of operations,seize in time the operation opportunity,select proper procedures,to boost cure rate and reduce mortality rate.

关 键 词：老年 急性 肠梗阻 诊治 手术 

分 类 号：R574.2[医药卫生—消化系统]