老年结直肠癌患者并发急性肠梗阻患者的外科治疗分析

Analysis on efficacy of surgical treatment for acute intestinal obstruction caused by colon or rectal carcinoma in elderly patients

目的探讨老年结直肠癌并发急性肠梗阻患者外科治疗的疗效。方法回顾性分析我院收治的27例>60岁结直肠癌并发急性肠梗阻患者外科治疗术后的并发症以及术后死亡率。结果27例患者中,11例行急诊手术治疗,6例发生并发症,发生率54.55%,死亡1例,死亡率9.09%;16例行限期手术,7例发生并发症,发生率43.75%,死亡2例,死亡率12.5%,两类手术的并发症发生率以及死亡率差异没有统计学意义(P>0.05)。结论老年结直肠癌患者并发急性肠梗阻患者要严格把握急诊手术和限期手术的指征,手术方式以解除梗阻、抢救生命为首要考虑因素,可选择姑息性手术或根治性手术。

Objective To explore the effect of surgical treatment for acute intestinal obstruction caused by colon or rectal carcinoma in elderly patients. Methods Clinical data of 27 elderly patients （ above 60 years old） with colon or rectal cancer treated by operation in this hospital were retrospectively reviewed and analyzed. Results Eleven of 27 patients were treated with emergent operation. Postoperative complications occurred in 6 cases. The incidence was 54.55%. One case died and the mortality rate was 9.09%. Sixteen of 27 patients were treated with optional operation, postoperative complications occurred in 7 cases, and the incidence was 43.75%. Two cases died and the mortality rate was 12. 5%. There was no significant difference in incidence and mortality rate, P 〈 0.05. Conclusion The indications for emergent and optional operation in elderly patients with acute intestinal obstruction caused by colon or rectal cancer should strictly be mastered. Life - saving is the main reason for decision of types of surgical treatment for solving the obstruction, and the operation may be palliative or radical.