老年肠梗阻临床诊治剖析.docVIP

老年肠梗阻临床诊治剖析 　　[摘要] 目的 对老年肠梗阻的临床诊断及治疗方法进行系统探析。方法 方便收集2016年7月―2017年7月该院胃肠外科诊治的57例老年肠梗阻患者的临床资料，对患者的临床诊断和治疗情况进行分析和总结。 结果 该组患者中，病因均得到明确，包括肠道肿瘤19例，肠粘连12例，肠扭转9例，嵌顿性疝8例，肠系膜血管栓塞5例，肠套叠4例；37例患者合并≥1种基础病症，主要是高血压、糖尿病、脑血管疾病等；51例采取手术治疗，6例采取保守治疗（1例转手术治疗），治愈45例，好转10例，死亡2例；合并基础病患者临床治疗效果整体低于非合并症患者（Z=-1.032，P0.05）。结论 对于老年肠梗阻应早期确诊，明确具体病因，掌握合并症，采取针对性治疗方法，可实现良好预后，减少死亡发生。 　　[关键词] 老年；肠梗阻；诊断；治疗 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）02（a）-0041-03 　　Analysis of Clinical Diagnosis and Treatment of Senile Intestinal Obstruction 　　LI Jun 　　Department of Surgery， Section One， Huanghua People’s Hospital， Huanghua， Hebei Province， 061100 China 　　[Abstract] Objective This paper tries to make a systematic analysis of the clinical diagnosis and treatment of senile intestinal obstruction. Methods The clinical data of 57 elderly patients with intestinal obstruction diagnosed and treated in this hospital from July 2016 to July 2017 were convenient collected， and the clinical diagnosis and treatment were analyzed and summarized. Results The etiology of patients were clear， including 19 cases of intestinal cancer， 12 cases of intestinal adhesion， 9 cases of volvulus， 8 cases of incarcerated hernia， 5 cases of superior mesenteric artery embolization， 4 cases of intussusception； 37 cases with more than one kind of basic disease， mainly hypertension， diabetes and cerebrovascular disease； 51 cases underwent surgery treatment， 6 cases of conservative treatment （1 cases of surgical treatment）， 45 cases were cured， 10 cases were improved， 2 case died； clinical effect overall was lower than that of non-disease patients （Z=-1.032，P0.05）. Conclusion For elderly patients with intestinal obstruction， early diagnosis， specific etiology， complications and targeted treatment can achieve good prognosis and reduce death. 　　[Key words] Old age； Intestinal obstruction； Diagnosis； Treatment 　　?c梗阻是临床常见的急腹症，就是肠内容物无法正常运行和顺利经过肠道的病症。该病不但会导致肠管解剖形态及功能改变，同时还会引起全身性生理紊乱，病情严重的威胁到生命安全。出现肠梗阻的病理生理改变主要是因为体液丧失、肠管膨胀、毒素吸收，会导致感染