老年人自发性乙状结肠穿孔诊治体会(附8例报告)  

Diagnosis and treatmenet of spontaneous sigmoid perforation of the aged:an analysis of 8 cases

作　　者：庄树彤[1] 陈斌[1] 郑凯[1] 徐敏[1] 

机构地区：[1]广东省深圳市第二人民医院胃肠外科,广东深圳518035

出　　处：《中国医学工程》2013年第5期16-17,共2页China Medical Engineering

摘　　要：目的探讨老年患者自发性乙状结肠穿孔的临床特点。方法对我院收治的8例老年自发性乙状结肠穿孔患者的临床表现、辅助检查、手术方式等资料进行回顾性分析。结果本组患者平均年龄70.6岁,8例患者均经手术探查证实为自发性乙状结肠穿孔,术前误诊6例(75%),行穿孔段结肠外置造瘘2例,穿孔修补+近端结肠造瘘4例,病变段结肠切除+近端结肠造瘘2例。治愈7例(87.5%),死亡1例(12.5%)。结论老年患者自发性乙状结肠穿孔缺乏特异性临床表现,术前误诊率高。早期正确诊断、及时合理的外科治疗是改善预后的关键。[ Objective ] To study the clinical characteristics of spontaneous sigmoid perforation of the aged. [ Methods ] Retrospective analysis the clinical data of the 8 patients administered to our hospital. [ Resluts ] The average age in our study was 70.6 years old.All the 8 cases of spontaneous sigmoid perforation were confirmed by operation.6 of them were misdiagnosed. 2 cases underwent double luminal coIostomy of the perforated colon, 4 cases underwent repair of perforation plus proximal colostomy, and 2 cases underwent resection of the perforated colon plus proximal colostomy. 7 cased （87.5%） were cured and 1 case （12.5%） died. [ Conclusions I There are hardly specific clinical manifestation for spontaneous sigmoid perforation of the aged.The misdiagnosis rate is high. The key to the successful rescue is the early and accurate diagnosis, timely and reasonable surgical therapy.

关 键 词：自发性穿孔 乙状结肠穿孔 诊断 治疗 

分 类 号：R574.62[医药卫生—消化系统]