老年人急性肠梗阻的病因及其处理

Pathogeny and Treatment of Acute Intestinal Obstruction in the Elderly

目的探讨老年人急性肠梗阻的病因及其处理方法。方法回顾性总结分析1993年5月-2006年12月收治的110例经手术证实、60岁以上的急性肠梗阻患者的临床资料。结果本组肠梗阻的病因中:肿瘤53例(48.2%),肠粘连25例(22.7%),腹外疝15例(12.6%),肠扭转6例(5.5%),肠套叠4例(3.6%),肠腔内粪石、异物5例(4.5%),肠系膜血管栓塞2例(1.8%)。术后并发症39例次,占35.5%,死亡8例,占7.3%。结论老年急性肠梗阻的主要病因为肿瘤,腹外疝、肠粘连分别为第二、三位的病因。加强围手术期处理,重视老年患者合并的全身疾病,早期正确诊断、合理手术可有效降低术后并发症和病死率。

Objective To analyze the pathogeny and treatment of acute intestinal obstruction in aged patients. Methods A retrospective analysis of 110 cases over 60 years of age with acute intestinal obstruction undergoing surgery from May 1993 to December 2006 was carried out. Results Of these cases, obstruction caused by tumor, adhesion, hernia, volvulus, intussusception, intestinal cavity fecalith and foreign material, and mesenteric vascular embolization accounting for 48.2% , 22.7%, 12.6% , 5.5 % , 3.6% ,4.5 % , 1.8% respectively. 39 （ 35.5 % ） complications occurred after operation, 8 （ 7.3 % ） cases died due to complications. Conclusion The main cause of acute intestinal obstruction in aged patients was tumor. Volvulus was secondary and hernia thirdly. Mortality after operation was effectively reduced by strengthening peri-operative treatment, early correct diagnosis and rational operation.