老年肠梗阻154例临床诊疗剖析.docVIP

老年肠梗阻154例临床诊疗剖析 　　【摘要】 目的：探讨老年肠梗阻患者的临床特点、治疗方法和临床结局，为老年肠梗阻的诊疗提供参考。方法：回顾性分析2008年1月-2013年12月青岛大学附属医院急诊普外科收治的154例老年（年龄≥60岁）肠梗阻患者的临床资料，统计患者的梗阻原因、治疗方式、住院天数、合并症及病死率。结果：154例老年肠梗阻患者中，前3位的病因是肿瘤、肠粘连、嵌顿疝。手术治疗95例，保守治疗59例。保守治疗患者住院天数短于手术治疗患者，两组比较差异有意义统计学意义（P0.05）。结论：（1）肿瘤性肠梗阻是老年性肠梗阻最常见病因，其次为粘连性肠梗阻、嵌顿疝肠梗阻。（2）合并症影响老年肠梗阻患者的治疗结果。（3）老年性肠梗阻的手术治疗指征应适当放宽。 　　【关键词】 老年患者； 肠梗阻； 诊断； 治疗 　　中图分类号 R574.2 文献标识码 A 文章编号 1674-6805（2015）4-0005-03 　　Diagnosis and Treatment in Elderly Patients with Intestinal Obstruction -A Retrospective Analysis of 154 cases/FU Chun-yu，LI Shi-kuan，SHI Wen-chao，et al.//Chinese and Foreign Medical Research，2015，13（4）：5-7 　　【Abstract】 Objective：To investigate the clinical characteristics，treatment and clinical result of the elderly with intestinal obstruction，by which it will provide reference for the diagnosis and treatment of the elderly intestinal obstruction.Method：We collected 154 cases of the elderly intestinal obstruction from January 2008 to December 2013 in the Affiliated Hospital of Qingdao University Medical College.Aggregately analyzed etiology，treatment and length of stay，coexisting diseases and fatality rate of patients.Result：In 154 cases，the top three etiologies were neoplasm，adhesion and hernia.There were 79 patients underwent surgical operation and 75 patients received expectant treatment.The length of stay of expectant treatment patient’s was significantly shorter than that of surgical patients（P0.05）.Conclusion：（1）Neoplasm is the commonest reason leading to the elderly intestinal obstruction，this is followed by adhesive and hernia.（2）The coexisting diseases affect the clinical result of elderly intestinal obstruction.（3）The operative indication of elderly intestinal obstruction should be properly relaxed. 　　【Key words】 Elderly patients； Intestinal obstruction； Diagnosis； Treatment 　　First-author’s address：Qingdao University Medical College，Qingdao 266003，China 　　doi：10.14033/j.cnki.cfmr.2015.04.003 　　肠梗阻是外科常见的病症。随着社会人口老龄化，近年来老年性肠梗阻发病率呈逐年递增的趋势