城市老年人和成年人急性肠梗阻病因及治疗分析

Analysis of cause and treatment of acute intestinal obstruction in different age groups in metropolitan

目的 分析城市老年人和成年人急性肠梗阻的病因及治疗效果。方法 回顾分析我院自１９９５年１月至１９９９年１２月收治的急性肠梗阻１６５例。年龄大于或等于６０岁的为老年组，年龄小于６０岁的为成年组。结果 １６５例中，老年组９８例，成年组６７例。全组共有结直肠肿瘤６８例，肠粘连４５例，其他肿瘤腹腔广泛转移１３例，乙状结肠扭转１０例，斜疝７例，原因不明９例以及其他原因１３例肿瘤患者在老年组中占４４.９％（４４／９８），成年组中占５５.２％（３７／６７），差异无显著性（Ｐ＞０．０５）；肠粘连老年组中占３０．６％（３０／９８），成年组中占２２．４％（１５／６７），差异无显著性（Ｐ＞０．０５）；乙状结肠扭转老年组中占３．１％，成年组中占１０．４％，差异有显著性（Ｐ＜０．０５）；肿瘤患者中，老年组有７９．５％接受了手术，成年组有９４．６％接受了手术，差异有显著性（Ｐ＜０．０５），老年组和成年组结直肠肿瘤的切除率分别为５１．４％和５４．５％，差异无显著性（Ｐ＞０．０５）。全组死亡９例，老年组病死率７．１％（７／９８），成年组为２.９％（２／６７），差异有显著性（Ｐ＜０．０５）。结论（１）肿瘤是城市居民肠梗阻的主要病因；（２）急性肠梗?

Objective To analyze the cause and therapeutic effect of acute intestinal obstruction of different age groups in metropolitan. Method The data of 165 cases of acute intestinal obstruction admitted in our department from January 1995 to December 1999 were analyzed retrospectively. Patients over 60 belonged to aged group and the ones below 60 belonged to adult group. Results Among 165 cases, 98 cases belonged to the aged group while 67 belonged to the adult group. There were 68 cases of colorectal cancer, 45 cases of adhesion, 13 cases of cancer metastasis, 10 cases of volvulus of sigmoid colon, 7 cases of oblique hernia and 22 cases of other causes. Cancer was the main cause in the aged group (44. 9%, 44/98) and adult group (55. 2%, 37/67) (P >0.05). Adhesion accounted for 30.6% (30/98) and 22.4% (15/67) in these two groups. 79.5% of the patients with colorectal cancer in the aged group and 94.6% in the adult group recieved operation ( P < 0. 05) . The resection rate of colorectal cancer was almost the same between the two groups. The mortality was 7. 1% (7/98) in the aged group and 2.9% (2/67) in the adult group respectively( P < 0.05) . Conclusions Tumor is the main cause of acute intestinal obstruction in metropolitan followed by adhesion. The mortality is significantly high in aged group.