摘要
目的 探讨老年人上消化道穿孔的临床特点 ,提高其诊断与治疗水平。 方法 回顾性分析收治的83例老年上消化道穿孔的临床资料。 结果 3 9例 ( 46 % )患者临床症状不典型。发病至手术时间在 12h之内死亡及并发症发生率分别为 2 5 %及 3 6 7% ;超过 12h为 11 5 %及 5 3 8%。 6 7例行急症手术治疗 ,行穿孔修补术 5 6例 ,死亡 3例 ,行胃大部切除术 11例 ,死亡 1例 ,手术死亡率为 6 %。保守治疗 16例 ,死亡 4例 ,死亡率为 2 5 %。 结论 老年人上消化道穿孔症状往往较隐匿 ,应尽早诊断 ,及时手术治疗并警惕胃癌穿孔的可能性。手术方法以穿孔修补术较为安全。
To investigate the clinical characteristics of superior digestive tract perforation in the elderly and to improve level of diagnosis and treatment. Methods 83 elderly patients with superior digestive tract perforation were reviewed and followed up. Results 46% of elderly patients were vague clinical presentation.The incidence of complication and mortality were 36 7% and 2 5% respectively when operation was performed within 12 hours from the time of acute onset;53 8% and 11 5% were more than 12 hours.67 cases were performed emergent operation;the method:Omental patch closure for 56 cases and 3 cases died;partial gastrectomy for 11 cases and 1 case died.Operative mortality was 6%.16 patients were treated conservatively and 4 cases died (25%). Conclusions The symptoms of perforate superior digestive tract are concealed in the elderly.Early diagnosis and operation is necessary.The simple closure is safe in aged patients.Particularly we found that gastric perforation was often accompanied by the cancer in the elderly.
出处
《实用老年医学》
CAS
1999年第6期299-300,共2页
Practical Geriatrics
关键词
上消化道穿孔
外科手术
死亡率
老年人
Perforation Superior digestive tract Surgery Mortality (Original article on page 299)
