老年人自发性结直肠穿孔56例临床分析

目的：对老年人自发性结直肠穿孔的病因、诊断及处理加以分析。方法：回顾性分析56例自发性结直肠穿孔患者的临床资料。结果：本组56例均为60岁以上的老年患者,多以急腹症就诊,无特异性临床表现,早期诊断困难;本组死亡14例。结论：老年患者大多伴有便秘、结肠动脉硬化血供差、癌肿发病率高是自发性结直肠穿孔的主要原因,术前易误诊,应尽早剖腹探查,充分引流,积极加强对围手术期的监护和综合治疗可降低死亡率。

Clinical Analysis on Spontaneous Perforation of Clone and Rectum in 56 Old Patients

Objective： To analyze the cause, diagnosis and treatment of spontaneous perforation of clone and rectum in old people. Method： The clinial information of 56 cases with spontaneous perforation of clone and rectum were retrospectively analyzed. Result： All the 56 cases were more than 60 years old. Most of them were suspected as acute abdomen with no specific clinical manifestation, an early diagnosis is extremely difficult; 14 cases died. Conclusion： The major reasons of spontaneous perforation of clone and rectum are constipation, poor blood supply due to arteriosclerosis of colon, and high incidence of cancer. It is likely to be misdiagnosed. Early exploratory laparotomy, sufficient drainage, and strengthening of monitoring during perioperative period can reduce mortality rate.