老年人乙状结肠穿孔的诊治（附35例报道）

目的：探讨老年人乙状结肠穿孔的临床特点和诊治经验。方法：回顾性分析35例老年人乙状结肠穿孔患者的临床资料。结果：本组35例中,肿瘤性穿孔9例,非肿瘤性穿孔26例。所有患者均行急诊剖腹探查术,术后因感染性休克或多器官功能衰竭死亡13例（37.1%）,存活22例（62.9%）,术后再发穿孔行二次手术5例,伤口感染8例,伤口裂开行二期缝合2例。结论：老年人群乙状结肠穿孔有时缺乏特异性临床表现,综合分析病史、体征及辅助检查,准确判断手术指征和手术治疗是改善预后的关键。

Diagnosis and treatment of perforation of the sigmoid colon in 35 cases

Objective：To explore the clinical characteristics and treatment strategy of perforation of the sigmoid colon of elder patients.Method：The clinical data of 35 cases with perforation of the sigmoid colon were analyzed retrospectively.Result：Nine patients have perforation of the sigmoid colon with tumor and twenty-six with non-tumor in all 35 cases.All patients underwent emergent surgical treatment.After operation,13 patients died of septic shock or MODS（37.1%） and 22 cases were cured（62.9%）,5 cases underwent reoperation because of reperforation,8 cases got the infection of incisions,2 cases had disruption of the wound requiring reoperation.Conclusion：The perforation of the sigmoid colon without specific clinical manifestations sometimes.To analyseanalyze the case history,medical examination and adjunct examination,combine early diagnosis and appropriate surgical treatment are significant to improve the prognosis.To explore the indications and operation on time is also the key point for improving curative effect.