老年人急性腹膜炎临床研究.docVIP

老年人急性腹膜炎临床研究 　　【摘要】目的 探讨老年人急性腹膜炎的临床发病特征以及影响后期恢复的因素，做好前期的处理， 以提高老年人急性腹膜炎的疗效。方法 对我院2005年6月~2010年10月收治的64例年龄在 60 岁以上的急性腹膜炎的老年患者并行急诊剖腹手术回顾分析其临床资料。结果 老年人急性腹膜炎绝大多数并不表现出典型的临床特征，首次就诊的时间较晚平均38h，手术的时间（患者感到腹痛到手术的时间平均65.3h)，术后并发症( 37.5%)以及死亡率(23.4 %)均较高。结论 老年急性腹膜炎的患者后期的恢复情况与就诊时间、发病到手术的时间、原发疾病以及并发症的类型等因素有关，在手术前后的处理应该做到及早的诊断并积极准备手术，同时密切关注患者的生命体征以及预防器官衰竭的治疗，控制各种并发症的发生。 　　【关键词】老年人 急性腹膜炎 临床研究 　　中图分类号：R656.41 文献标识码：A 文章编号：1005-0515（2011）5-006-02 　　Clinical study of elderly patients with acute peritonitis 　　Xuwen County Second Peoples Hospital 　　Li ChunZhao ZetongPan Rixing 　　【Abstract】Objective To investigate the clinical onset of acute peritonitis old features and the factors that affect late recovery and do pre-processing to improve the efficacy of elderly patients with acute peritonitis. Methods From June 2005 ~ October 2010 64 patients were admitted over the age of 60 elderly patients with acute peritonitis in emergency abdominal surgery in parallel to analyze the clinical data review. Most elderly patients with acute peritonitis Results did not show typical clinical features, the first time for consultation later average 38h, operation time (patients feel pain to the average operation time of 65.3h), postoperative complications (37.5% ) and mortality (23.4%) were higher. Conclusions Elderly patients with acute peritonitis and the recovery of post-treatment time, time of onset to surgery, primary disease and complications of type and other factors, and postoperative treatment in early diagnosis and should be actively preparing for surgery, while keeping concerned about the vital signs of patients with the treatment and prevention of organ failure, the control of various complications. 　　【Key words】aged Acute peritonitis Clinical Research 　　 　　随着我国逐渐步入老龄化社会，老年人的各种疾病的发病率也在升高，而且往往多危及生命，急性弥漫性腹膜炎是危重疾病之一[1]。而老年人患有此病往往病情较为严重，预后较差，并发症较多死亡率也高。由于老年人自身的特点，往往对该病的早期判断并不是较为明确，因此为了更加全面分析老年急性腹膜炎的病情以及诊断，为以后针对老年急性腹膜炎的治疗，对我院2005年6月~2010年10月收治的明确诊断的老年急性腹膜炎64例患者进行回顾性分析，现报告如下。 　　1 临床资料