A Retrospective Analysis Of The Perioperative Managements Of 135 Elderly Patients Aged 80 And Over With Acute Abdomen

Objective:Elderly patients aged 80 and over with acute abdomen are in a critical condition,which have higher perioperative mortality.The purpose of the research is to explore measures that can improve cure rate of elderly patients with acute abdomen in perioperative management.Methods:A retrospective analysis of clinical characteristic on 135 elderly patients aged80 and over with acute abdomen that treated by emergency surgery from the date of2012.07 to 2014.03.To analyze and summarize operative treatment methods to improve survival rate of perioperative management Statistical data followed up 6 months.Results:In 135 patients aged 80 and over with acute abdomen who underwent emergency surgical treatment of elderly patients(age ranges:80-101 years, average85.3±2 years of age;73 men and 62 women):The patients that come to see a doctor when suffered disease within 12 hours are 25,12 to 24 hours are 58,24 to 48 hours are45,48 hours and over are 7.Complications:there are 45 patients with hypertension,38 with coronary disease,16 with arrhythmia,8 with cerebral infarction,39 with diabetes mellitus,10 with chronic bronchitis,21 with pulmonary infection,3 with toxuria,3 with coagulation disorders and 1 patient with bleeder disease.All of the 135 elderly acute abdomen patients underwent emergency laparotomy operation.99 cases were cured,2cases died of traffic accidents and brain hemorrhage during the follow-up;4cases are lost of follow up;24 patients were improved, automatic discharge(or transfer)in 5 cases,of which 2 cases died and 1 lost of follow up; 7 cases died, 2 cases died of sepsis caused by MODS,2 cases died of myocardial infarction,2 cases died of acute pulmonary embolism, 1 case died of brain stem hemorrhage,the hospital mortality was5.19%.A total of 123 patients were followed up and The follow-up rate is 96.09%,the survival rate is 91.41% during the 6-months-followed-up.46 cases of complications:20cases with incision infection, 10 cases of pulmonary infection, 9 cases of cognitive impairment after operation, 5 cases of stress ulcer bleeding, 2 cases of deep venous thrombosis of lower extremity.Conclusion:Elderly patients aged 80 and over with acute abdomen are in a critical andcomplex condition as well as in a higher operation risk.We should take the rescue life as the ultimate goal other than too many preoperative examination before the surgery.It is helpful to improve the survival rate in perioperative period that we should make actively preoperative preparation,Shortening the preoperative preparation time,prevention and treatment of infection and shock and restrictive liquid recovery early in uncontrolled hemorrhagic shock patients,choice of individual operation scheme accordingly,and damage control operation necessarily,multidisciplinary cooperative treatment for the elderly patients that have many coexistence of diseases,and the main purpose is to prevent MODS and treat complication of respiratory tract infection as well as strengthen nutrition support.