老年性结直肠穿孔103例临床分析

Clinical Analysis of 103 Cases of Colorectal Perforation in Aging Patients

目的探讨老年性直肠穿孔的发病原因,治疗方式及预后,提高救治成功率。方法回顾性分析我院2003年1月-2013年1月共103例结直肠穿孔患者的临床资料.结果 103例患者,其中肿瘤性梗阻穿孔75例、便秘性穿孔23例、医源性穿孔3例,异物导致穿孔2例;升结肠11例、横结肠7例、降结肠76例、直肠上段9例;术后切口感染43例,死亡21例。结论老年性结直肠穿孔肿瘤性疾病居多,不能忽视便秘导致的穿孔,一旦明确,积极手术,积极抗休克治疗是降低死亡率的关键。

Objective To approach the pathogeny of Colorectal perforation in aging, therapeutics and prognosis, Which would be to improve the achievement ratio of the treatment. Methods Retrospective analysis of the clinical data of 103 cases of Colorectal perforation from Jan. 2003 to Jan 2013 in our hospital. Result All of the 103 cases,75 had perforation caused by obstruction of tumor;23 caused by constipation,3 caused by iatrogenic,2 caused by foreign bodies; The perforation located on the different part of colorectal,there 11 in ascending colon,7 in colon transversum, 76 in descending colon（including the junction of rectum）,9 in superior rectum;The complications of these patients：43 had postoperative infection,55 had pulmonary infection,2 had arrhythmia,21had died. Conclusion The colorectal perforation in aging patients mostly caused by tumor,but we can＇t neglected the constipation to result in perforate.We must have operation on the patients who we make sure that is perforation. The active treatment of Countershock is criticality to reduced the rate of death.