老年急性肠梗阻的危险因素及外科治疗分析

目的]分析老年急性肠梗阻的危险因素并探讨外科治疗特点.方法]选择2009年1月至2011年12月在我院接受治疗的69例老年急性肠梗阻患者为研究对象,对其临床资料做回顾性分析.结果]患者中39例肠道肿瘤和18例肠粘连,分别占老年急性肠梗阻患者主要病因的56.52％和26.09％；54例(78.26％)合并基础性疾病,其中14例伴有两种以上的基础性疾病.患者痛程(从感觉到疼痛等症状到就医确诊的时间)8h～13d.患者中42例(60.87％)手术时出现耐受力问题(出现严重负氮平衡、水、电解质失衡或酸碱失调、非正常血压等)；4例(5.80％)死亡；15例(21.74％)有并发症.结论]老年急性肠梗阻的危险因素包括患者合并严重基础性疾病、就诊不及时和手术耐受能力下降等；及早诊断、及早治疗,选择合适的手术时机、方式并加强围手术期治疗,可降低手术病死率及并发症的发生.

Analysis of Risk Factors and Surgical Treatment in Acute Intestinal Obstruction in Aged

Objective] To analyze the risk factors and surgical treatment in acute intestinal obstruction in aged.Methods] The 69 elderly patients with acute intestinal obstruction from January 2009 to December 2011 were selected as the research objects and clinical data were analyzed retrospectively.Results] Intestinal tumour（56.5%） and intestinal adhesion（26.1%） were the main causes for acute intestinal obstruction in aged;Complicated serious basic disease,delayed adminission and poor operation tolerance were risk factors in acute intestinal obstruction in aged;15 cases（21.7%） were accompanied with compications and 4 cases（5.80%） died.Conclusion] The risk factors in acute intestinal obstruction in aged were a history of serious basic disease,delayed adminission and poor operation tolerance.Early diagnosis and treatment,selecting properly operative time and approach and strengthening perioperative nursing may reduce operative mortality and complications.