摘要
目的探讨老年人上消化道穿孔的特点及外科治疗方式。方法回顾分析1999年6月～2008年09月143例老年人上消化道穿孔患者的诊治情况。结果119例行手术治疗,穿孔修补101例,胃大部切除18例;24例行非手术治疗。手术组治愈102,死亡17例;非手术组治愈18例,死亡6例。75岁以下年龄组术后并发症发生率及死亡率低于75岁以上年龄组(P<0.05);发病至手术时间l2h以内组并发症发生率、死亡率低于l2h以上组(P<0.01);合并单种并存病组的并发症发生率、死亡率低于两种或以上组(P<0.05,P<0.01)。不同手术方式在并发症发生率上差异有统计学意义(P<0.05)而死亡率差异无统计学意义(P>0.05)。结论对老年上消化道穿孔的治疗应细分为高龄组和超高龄组,高龄组以手术治疗为主,手术方式以穿孔修补为主;超高龄组的治疗方式应遵循个体化原则。
【Objective】To ivestigate the clinical features and therapeutic ways of the gastroduodenal ulcer perforation （GDUP） in aged patients. 【Methods】The clinical data of 143 cases with age more than 60 years treated in recent nine years in our hospital were analysed retrospectively.【Results】Among the 143 patients,119 patients underwent operation. Simple closure operation was performed in 101 cases and subtotal gastrectomy in the other 18 cases. 24 cases were treated with non-operative methods. 102 cured and 17 died in operation group; 189 cured and 6 died in non-operative group. The mortality and complications rate were significantly lower in the patients less than 75-year old than those in the patients more than 75-year old （P〈0.05）; and also lower in disease history less than 12 hours than those in over 12 huors （P〈0.01）. The mortality and complications rate in patients with single accompaning disease was lower than that in patients with multiple accompaning diseases （P〈0.01）. The operative methods did not correlate with mortality,but with the complications. 【Conclusions】Aged patients with GDUP would be treated according to the age. Less than 75-year old patients should be operated as early as possible. Simple closure operation is a better choice. More than 75-year old should be treated respectively.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第1期120-122,共3页
China Journal of Modern Medicine
