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目的探讨高龄急腹症患者围手术期并发症防治的有效方法。方法回顾性分析2006年1月至2009年7月普外科诊治的12例80岁以上高龄急腹症患者的临床资料。急性阑尾炎行阑尾切除术6例,急性阑尾穿孔行阑尾切除术加腹腔引流术2例,结石性胆囊炎胆囊穿孔行胆囊切除术加腹腔引流术2例,直肠癌并肠梗阻行乙状结肠造瘘术1例,嵌顿性股疝并肠坏死行肠切除术1例。结果 1例术后出现心力衰竭、心律失常经治疗痊愈出院,1例术后出现肺内感染治愈,1例出现切口感染延期愈合,1例术后出现多器官功能障碍综合征死亡。8例未发生围术期并发症痊愈出院。结论高龄急腹症患者脏器功能减退且多并存有不同的器官病变,围手术期风险极高,采用多学科协作做好术前评估,围手术期针对性给予处理和预防,能够有效地降低并发症的发生率,提高高龄急腹症患者的治愈率。
Objective To investigate the effective methods of prevention and treatment of perioperative complications in elderly patients with acute abdomen. Methods The clinical data of 12 patients with acute abdomen over the age of 80 from January 2006 to July 2009 were analyzed retrospectively. 6 cases of acute appendectomy appendectomy, appendectomy appendectomy plus abdominal drainage in 2 cases, gallstone cholecystitis gallbladder perforation cholecystectomy plus abdominal drainage in 2 cases, rectal cancer and intestinal obstruction sigmoidostomy 1 case, incarcerated femoral hernia and bowel necrosis bowel resection in 1 case. Results One patient had heart failure after operation. Arrhythmia was cured and discharged after treatment. One patient had lung infection after operation, one patient had delayed wound healing, and one patient died of multiple organ dysfunction syndrome after operation. 8 cases without perioperative complications cured and discharged. Conclusion The organ dysfunction in elderly patients with acute abdomen and multiple organ diseases, perioperative risk is extremely high, using multidisciplinary collaboration preoperative evaluation, perioperative targeted treatment and prevention, can effectively reduce The incidence of complications, improve the cure rate of elderly patients with acute abdomen.