老年结直肠癌合并急性肠梗阻的诊断与治疗

Analysis and treatment of colorectal carcinoma with obstruction in elderly patients

目的:探讨老年结直肠癌并急性肠梗阻的临床特点、诊断和治疗。方法:对本院2003年1月至2008年1月收治的42例老年结直肠癌并急性肠梗阻患者的临床资料进行回顾性分析。全组右半结肠癌并梗阻8例,左半结肠癌并梗阻30例,直肠癌并梗阻4例。全组均经急诊手术治疗,采用右半结肠一期切除吻合8例,左半结肠一期切除吻合20例,Hartmann手术10例,横结肠造瘘术4例。结果:全组无术中死亡。术后出现并发症14例,包括吻合口瘘3例、切口感染11例、腹腔感染3例、肺部感染1例。结论:老年结直肠癌并急性肠梗阻的治疗要根据患者具体病情综合分析,选择合理的治疗方式是提高疗效、减少并发症的重要保证。

Objective： To investigate the clinical characteristics, the diagnosis and treatment of colorectal carcinoma with obstruction in elderly patients.Methods：42 cases of colorectal carcinoma with obstruction in elderly patients from January Ist 2003 to January 1st 2008 in our hospital were retrospectively analyzed. There were 8 cases of right - side colonic carcinoma, 30 cases of left - side colonic carcinoma and 4 cases of rectal carcinoma in the group. All patients received emergency operation. One stage tumor resection and anastomosis was performed in 8 cases of fight - side colonic carcinoma and in 20 cases of left - side colonic carcinoma. Hartmann operation was performed in 10 cases. Palliative colostomy was performed in 4 cases. Results： All the cases had no intraoperative death. Postoperative complications occurred in 14 cases, including anastomosis fistula, incision infection, intraperitoneal infection, pulmonary infection. Conclusion： The clinical treatment of colorectal carcinoma with obstruction in elderly patients should be according to the comprehensive analysis of the patients＇ condition. The reasonable treatment is the important guarantee of improving the curative effect and reducing the complication.