老年与中青年急性肠梗阻临床特征分析

目的探讨不同年龄段肠梗阻患者的临床特点、治疗方法、疗效及预后转归。方法回顾性分析2010年1月至2020年3月320例肠梗阻患者的临床资料,按年龄分为老年组(≥60岁)和中青年组(<60岁),比较两组患者的临床表现、梗阻原因、治疗方法、住院天数及疗效转归等。结果中青年组腹痛和肛门停止排便排气症状比较突出,就诊比较及时,白细胞升高比例较高,老年组以腹胀和呕吐症状为主,两组比较差异有统计学意义(P<0.05)。肠梗阻病因排在前三位的分别是肠粘连、肿瘤、粪石。其中肠粘连中青年组多于老年组(P<0.05),肿瘤及粪石老年组均多于中青年组(P<0.05,P<0.01)。中青年组住院时间较短,疗效优于老年组(P<0.05)。结论不同年龄段肠梗阻其病因、临床表现均存在差异,晚期肿瘤和粪石是导致老年人肠梗阻的重要原因,老年人对症状不够敏感,就诊不及时,导致住院时间延长。

Objective To investigate the clinial characterstics,treatment,therapeutie fft and prognosis of bowel obstruction patents in ifferent age groups.Methods A rtropective amalysis of 320 patients with bowel obstruction from January 2010 to March 2020 was made.The subjects were divided into 2 age groups(old patients aged≥60 years,young and middle patients aged<60 years).The clinical manifestation,the cause of obsrnuction,therapies,hospital stay and prognosis were compared between 2 groups.Results The young and middle-aged patients performed noticeable symptoms of abdominal pain and rregular defecation and flatus,fllowing the timely treatment and diagnosis of higher leukocytosis.The older patients mainly performed abdominal distention and vomit.Statistical dfferences were observed in two groups(P<0.05)。The top three causes of bowel obstruction were intestinal adhesion,tumor and stercorolith.The symptom of intestinal adhesion was more common in young and middle-aged group than old-aged group(P<0.05),the symptoms of tumor and serrcorolith were more ommon in old-aged group than the other one(P<0.05,P<0.01).Young and middle-aged group showed shorter length of stay and better prognosis than old-aged group(P<0.05).Conclusion The dfferences of cause and clinical characteristics existe in two groups.Advanced tumor and stercorolith are main cause of old bowel obstrucion patients.Insensitivity of symptoms and delay in treatment lead to the longer length of stay of old patients.