老年性急性假性结肠梗阻的手术时机探讨

Surgical Opportunity for Elderly Patients with Acute Colonic Pseudo-obstruction

目的探讨老年性急性假性结肠梗阻的早期诊断与治疗,正确掌握手术时机。方法 回顾性分析6例急性假性结肠梗阻手术治疗患者的临床资料。结果 6例患者均经保守治疗无效,结肠扩张明显或有腹膜炎、肠穿孔等临床表现,转手术治疗后5例治愈,1例因肠穿孔合并中毒性休克、多脏器衰竭死亡。结论要提高对老年性急性假性结肠梗阻的认识,早期诊断,在积极保守治疗的同时要动态观察患者腹部体征,进行必要的手术干预。

Objective To explore the surgical opportunities for elderly patients with acute colonic pseudo-obstruction（ACPO）. Methods The clinical data of 6 elderly patients with ACPO were retrospectively analyzed. Results All 6 patients poorly responded to expectant treatment.Their clinical manifestations included colonic over-dilatation,peritonitis,and intestinal perforation.After surgical treatment,5 patients were cured and one patient died of toxic shock and multiple organ failure. Conclusion The awareness of ACOP should be strengthened to achieve early diagnosis.The abdominal sign should be dynamically monitored during expectant treatment,and surgical intervention should be considered when necessary.