老年人梗阻性结肠癌的临床特点和围手术期处理  

Clinical characteristic and perioperative management of colonic obstruction caused by colonic carcinoma in elderly

作　　者：沈其猷[1] 王斌[1] 张春新[1] 刘钦志[1] 

机构地区：[1]广东省东莞市虎门医院外科,523902

出　　处：《中国医师进修杂志》2012年第2期17-19,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨老年人梗阻性结肠癌的临床特点和治疗方法。方法回顾性分析2000年1月至2010年11月老年人梗阻性结肠癌30例的临床特点和围手术期处理情况。急诊手术11例，限期手术19例。一期切除吻合术26例（86．7％），短路性肠吻合术或单纯造瘘术4例（13．3％）。结果30例患者住院22—56d。术后出现切口感染5例，切口液化3例，切口裂开2例，吻合口瘘2例，肺部感染3例。围手术期死亡2例。结论对于老年人梗阻性结肠癌，除尽早作出诊断外，还要根据病情作适当的围手术期处理。选择合适的手术时机和合理的手术方式是提高临床疗效的关键。Objective To discuss the clinical characteristic and perioperative management of colonic obstruction caused by colonic carcinoma in elderly. Methods The clinical characteristic and perioperative management of 30 patients with colonic obstruction caused by colonic carcinoma from January 2000 to November 2010 were collected and analyzed retrospectively. Among 30 cases, 11 cases were accepted emergency operation, 19 cases were accepted limited operation. Resection and anastomosis at stage I was in 26 cases （86.7%）, shortcut surgery and simple fistulation was in 4 cases （13.5%）. Results The length of stay was 22-56 days. Postoperative complication including wound infection in 5 cases,wound liquescence in 3 cases, wound dehisce in 2 cases, anastomotic fistula in 2 cases, pulmonary infection in 3 cases. Two cases died during perioperative period. Conclusions Besides diagnosis as early as possible,appropriate perioperative management should be taken to the elderly patients, including reasonable operative time and surgical approaches and these are the keys to improve clinical curative effect.

关 键 词：老年人 结肠肿瘤 肠梗阻 外科手术 

分 类 号：R654.2[医药卫生—外科学]