老年肠梗阻69例诊断和治疗

Diagnosis and treatment of intestinal obstruction in the elderly:report of 69 cases

目的探讨老年人肠梗阻的临床特点、诊断和治疗。方法对2003年1月-2007年12月间经治疗的69例老年人肠梗阻的临床资料进行回顾性分析。结果非手术治疗35例(50.72%),手术治疗34例(49.28%),术后粘连引起的肠梗阻23例(67.65%),肿瘤引起的肠梗阻6例(17.65%),术后死亡4例(11.76%),致残2例(5.88%)。结论重视病史的全面采集,坚持正规的体格检查程序,严密观察病情,正确的临床逻辑思维,恰当的辅助检查,是早期诊断和成功治疗老年人肠梗阻的关键。老年人肠梗阻以粘连性肠梗阻、肿瘤性肠梗阻最常见,老年人肠梗阻手术风险较大。

Objective To explore the clinical characteristics, the diagnosis and treatment of the elderly patients with intestinal obstruction. Methods The clinical data of 69 cases of intestinal obstruction in the elderly from January 2003 to December 2007 in our hospital were collected and analyzed retrospectively. Results Among the 69 patients, 34 （49.28%）had operations performed and the other （50.72%）were treated conservatively. Twenty three cases （67.65%） were due to adhension post-operation, six cases （17.65%） of neoplasm, four cases（11.76%） died and two cases （5.88%） were disabled after operation. Conclusion The keys to early diagnosis and success treatment of intestinal obstruction in the elderly were paying more attention to the history collecting,correct sequence of physical examination,observing patients frequently and closely,logical intelleetion and exact adjuvant examinations.The most common causes of intestinal obstruction in the elderly are adhensions post-operation and neoplasia. The operation is danger for old patients.