老年人大肠癌并发急性梗阻的治疗  

The treatment of elderly acute obstructive colorectal carcinoma

作　　者：陈志棠[1] 刘建伟[1] 

机构地区：[1]暨南大学医学院第四附属医院广州市红十字会医院普外科,510220

出　　处：《中国综合临床》2003年第2期168-169,共2页Clinical Medicine of China

摘　　要：目的探讨老年人大肠癌并急性完全性梗阻的临床特点及治疗对策。方法回顾性分析 68例 70岁以上、确诊为大肠癌并急性完全性肠梗阻的病例 ,结合文献评价其临床特点及外科处理方法。结果 6例非手术治疗中 4例死亡 ,2例自动出院。 62例经手术治疗 ,其中一期右半结肠切除吻合 9例 ,一期左半结肠切除吻合 3 2例。其他术式 2 1例。术后并发症 2 2例 ,术后死亡 3例。结论结合老年人大肠癌并急性完全性梗阻的术前误诊率较高、晚期病例较多、并存病及术后并发症较多等特点 ,合理的术前检查及准备、重视并存病的处理、恰当的术式选择、有效的预防和治疗并发症是提高疗效的关键。适应证掌握恰当 。Objective To study the clinical features and management of elderly acute obstructive colorectal carcinoma.Methods 68 cases over 70 years old diagnoded as colorectal carcinoma with fully colorectal obstruction were retrospectively analyzed.The assessment on clinical features and surgical management was based on references.Results In 62 cases who were treated by operation,9 were treated with single stage right hemicolectomy and primary anastomosis,32 cases were treated with single stage left hemicolectomy and primary anastomosis and 21 cases were treated with other methods.After operation,complications occurred in 22 patients and 3 died.Conclusion The keys to improving curative effect of elderly obstructive colorectal carcinoma are reasonable examination and preparation before operation,proper selection of procedure,effective prevention and treatment for complication,due to the features like high rate of misdiagnosis,more advanced stage cases,more coexistent diseases and complications in the elderly obstructive colorectal carcinoma.Better knowledge of indication will contribute to the safety of single stage hemicolectomy and primary anastomosis.

关 键 词：老年人 大肠癌 并发症 急性梗阻 治疗 

分 类 号：R735.34[医药卫生—肿瘤]