老年胃十二指肠溃疡急性穿孔92例诊治分析

Treatment analysis of 92 cases of gastric and duodenal ulcer perforation in the aged

目的介绍老年人胃十二指肠溃疡急性穿孔的临床特点及治疗方法。方法对2008—2012年间该科收治的92例老年胃十二指肠溃疡急性穿孔患者进行分析,其中胃溃疡68例,十二指肠溃疡24例。结果治愈64例(69.6%),死亡8例(8.70%)。术后并发症20例(21.7%)。各类症状较治疗前有明显改善(P<0.05)。结论老年人胃十二指肠溃疡急性穿孔患者具有临床症状与体征不典型,容易误诊漏诊、合并症及并发症多等特点。只要围手术期准备充分,麻醉方式和术式选择得当,术中、术后观察严密,并给予合理的术后护理和有效治疗,老年患者也能对手术较好地耐受。

Objective To investigate the treatment experience and clinical characters of gastric and duodenal ulcer perforation in the aged.Methods Taking analysis to 92 old patients with gastric and duodenal ulcer perforation cases that received by our clinical department from 2008 to 2012 which be made up with 68 gastric and 24 duodenal ulcer perforation cases.Results There are 64 cases healed（69.6%）,8 cases of death（8.70%） and 20 cases with all sorts of complications（21.7%）,all symptoms significantly improved compared with the previous（P 0.05）.Conclusions The gastric and duodenal ulcer perforation in the aged have many types of clinical characters just like atypical clinical symptoms and signs,easy to misdiagnosis and misdiagnosis and lots of complications and complications,etc.We should get enough preparation,choose the best ways of anesthesia and surgery,intraoperative and postoperative monitoring closely and strengthen postoperative nursing care and a variety of effective treatment so that the old patients can well tolerate surgery.