老年人结肠癌合并肠梗阻的诊治体会

Diagnosis and treatment of aged patients with colonic cancer and intestinal obstruction

目的探讨老年人结肠癌并急性肠梗阻的诊断与治疗。方法回顾性分析2003年至2008年58例60岁以上结肠癌并急性肠梗阻病人的外科治疗资料。结果 58例中I期切除38例,Ⅱ期切除12例,捷径手术8例;58例中有伴发病者44例(75.9%),术后并发症17例(29.3%);手术死亡4例(6.9%)。结论手术切除是高龄结肠癌合并肠梗阻病人最好治疗方法,应早期诊断,早期治疗。重视围手术期的处理和选择合适手术方式是减少并发症、提高疗效的关键。

Objective To explore appropriate method for diagnosis and treatment of aged patients with intestinal obstruction caused by colonic cancer.Methods Surgical records of 58 patients with age range at 60 or over suffered from acute intestinal obstruction caused by colonic cancer during 2003 to 2008 were retrospectively analyzed.Results Among 58 patients,primary excision was done in 38 patients,second stage excision in 12,shortcut operation in 8.There were concomitant diseases found in 50 patients（75.9%）,postoperative complications occurred in 29.3% of patients,and operation related mortality was 6.9%.Conclusion Operative excision is the best way for treatment of colonic cancer in aged patients.Early diagnosis and treatment of the disease and appropriate management of concomitant diseases are very important.Recognition on perioperative management and appropriate operation mode were key measures for improving curative effect and reducing complications.