老年结肠癌梗阻56例临床特点与外科治疗

Clinical characteristics and surgical treatment for intestinal obstruction in 56 senile patients with colorectal carcinoma

目的 探讨近十年来老年结肠癌致肠梗阻有关临床特点的变化和外科治疗的有关问题。方法 对 1988年～ 1998年手术治疗 65岁以上老年结肠癌梗阻 5 6例进行回顾性分析和总结。结果 结肠癌梗阻占老年急性肠梗阻的5 0 .91% ,居首位 ;梗阻发生部位以右半结肠区最多 ,占 5 5 .3 6% ,左半结肠区仅占 14 .2 9% ;有非恶性肿瘤手术史的老年肠梗阻中 5 0 %是结肠癌所致 ,有恶性肿瘤手术史中 9.1%是原发结肠癌所致。结论 1.提高对老年结肠癌梗阻临床特点的认识 ,正确地选择手术时机和合理的手术方式能获良好预后 ;2 .加强围手术期各器官功能支持和营养代谢支持是减少死亡率的重要环节 ;3 .重视老年生理变化特点 ,警惕肿瘤所致的消化道症状 。

? Objective To investigate The changes of clinical characteristics and surgical treatment for obstruction in senile patients with colorectal carcinoma in recent decades.Methods From 1988 to 1998,56 patients with obstruction caused by colorectal carcinoma were analysed retrospectively.All of them were older than 65 years and treated by operation.Results Obstruction caused by colorectal carcinoma occupied 50.91% of all senile acute intestinal obstruction.The obstructive location was 55.36% in the right semicolon and 14.29% in the left semicolon.The colorectal carcinoma occupied 50% in the patients who had the operative history not for tumor,while occupied 9.1% in the patients who had the history of tumor resectomy.Conclusions 1.Promoting cognition of clinical characteristics of intestinal obstruction for senile colorectal carcinoma,selecting correct operative indication and method can improve the prognosis of the patients.2.Intensive perioperative support for the organic function and nutrient metablism are important to decraese the mortality.3.Awareness of the symptoms of digestive tract caused by tumor,the physical characteristics of senile patients and the early treatment for coloretal carcinoma can decrease the occurrence of intestinal obstruction. 〔