中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2015年
4期
5-7
,共3页
付春玉%李世宽%史文超%李元博
付春玉%李世寬%史文超%李元博
부춘옥%리세관%사문초%리원박
老年患者%肠梗阻%诊断%治疗
老年患者%腸梗阻%診斷%治療
노년환자%장경조%진단%치료
Elderly patients%Intestinal obstruction%Diagnosis%Treatment
目的：探讨老年肠梗阻患者的临床特点、治疗方法和临床结局，为老年肠梗阻的诊疗提供参考。方法：回顾性分析2008年1月-2013年12月青岛大学附属医院急诊普外科收治的154例老年(年龄≥60岁)肠梗阻患者的临床资料，统计患者的梗阻原因、治疗方式、住院天数、合并症及病死率。结果：154例老年肠梗阻患者中，前3位的病因是肿瘤、肠粘连、嵌顿疝。手术治疗95例，保守治疗59例。保守治疗患者住院天数短于手术治疗患者，两组比较差异有意义统计学意义(P<0.01)。102例患者存在合并症，存在合并症患者无论是手术治疗组还是保守治疗组住院天数均长于无并存疾病患者，差异有意义统计学意义(P<0.05)。死亡6例，保守治疗组死亡率高于手术治疗组，差异有统计学意义(P<0.05)。手术治疗组及保守治疗组有合并疾病组者死亡率均高于无合并疾病者，但差异无统计学意义(P>0.05)。结论：(1)肿瘤性肠梗阻是老年性肠梗阻最常见病因，其次为粘连性肠梗阻、嵌顿疝肠梗阻。(2)合并症影响老年肠梗阻患者的治疗结果。(3)老年性肠梗阻的手术治疗指征应适当放宽。
目的：探討老年腸梗阻患者的臨床特點、治療方法和臨床結跼，為老年腸梗阻的診療提供參攷。方法：迴顧性分析2008年1月-2013年12月青島大學附屬醫院急診普外科收治的154例老年(年齡≥60歲)腸梗阻患者的臨床資料，統計患者的梗阻原因、治療方式、住院天數、閤併癥及病死率。結果：154例老年腸梗阻患者中，前3位的病因是腫瘤、腸粘連、嵌頓疝。手術治療95例，保守治療59例。保守治療患者住院天數短于手術治療患者，兩組比較差異有意義統計學意義(P<0.01)。102例患者存在閤併癥，存在閤併癥患者無論是手術治療組還是保守治療組住院天數均長于無併存疾病患者，差異有意義統計學意義(P<0.05)。死亡6例，保守治療組死亡率高于手術治療組，差異有統計學意義(P<0.05)。手術治療組及保守治療組有閤併疾病組者死亡率均高于無閤併疾病者，但差異無統計學意義(P>0.05)。結論：(1)腫瘤性腸梗阻是老年性腸梗阻最常見病因，其次為粘連性腸梗阻、嵌頓疝腸梗阻。(2)閤併癥影響老年腸梗阻患者的治療結果。(3)老年性腸梗阻的手術治療指徵應適噹放寬。
목적：탐토노년장경조환자적림상특점、치료방법화림상결국，위노년장경조적진료제공삼고。방법：회고성분석2008년1월-2013년12월청도대학부속의원급진보외과수치적154례노년(년령≥60세)장경조환자적림상자료，통계환자적경조원인、치료방식、주원천수、합병증급병사솔。결과：154례노년장경조환자중，전3위적병인시종류、장점련、감돈산。수술치료95례，보수치료59례。보수치료환자주원천수단우수술치료환자，량조비교차이유의의통계학의의(P<0.01)。102례환자존재합병증，존재합병증환자무론시수술치료조환시보수치료조주원천수균장우무병존질병환자，차이유의의통계학의의(P<0.05)。사망6례，보수치료조사망솔고우수술치료조，차이유통계학의의(P<0.05)。수술치료조급보수치료조유합병질병조자사망솔균고우무합병질병자，단차이무통계학의의(P>0.05)。결론：(1)종류성장경조시노년성장경조최상견병인，기차위점련성장경조、감돈산장경조。(2)합병증영향노년장경조환자적치료결과。(3)노년성장경조적수술치료지정응괄당방관。
Objective:To investigate the clinical characteristics,treatment and clinical result of the elderly with intestinal obstruction,by which it will provide reference for the diagnosis and treatment of the elderly intestinal obstruction.Method:We collected 154 cases of the elderly intestinal obstruction from January 2008 to December 2013 in the Affiliated Hospital of Qingdao University Medical College.Aggregately analyzed etiology, treatment and length of stay,coexisting diseases and fatality rate of patients.Result:In 154 cases,the top three etiologies were neoplasm,adhesion and hernia.There were 79 patients underwent surgical operation and 75 patients received expectant treatment.The length of stay of expectant treatment patient’s was significantly shorter than that of surgical patients(P<0.01).There were 102 patients who had different coexisting diseases.Both surgical treatment group and expectant treatment group,the length of stay of the patients had coexisting diseases were longer than those who had no coexisting diseases,the different was significant.154 cases,there were 6 deaths.The fatality rate accounted for 1.05% in surgical treatment group,8.47% in expectant treatment group,there was statistical significance(P<0.05).However,there were no statistical differences between the patients had coexisting diseases group and had no coexisting diseases group(P>0.05).Conclusion:(1)Neoplasm is the commonest reason leading to the elderly intestinal obstruction,this is followed by adhesive and hernia.(2)The coexisting diseases affect the clinical result of elderly intestinal obstruction.(3)The operative indication of elderly intestinal obstruction should be properly relaxed.
