Diagnosis And Treatment Of Advanced Age Patients With Intestinal Obstruction(One Hundred And Three Cases Were Retrospectively Analyzed)

With the increasing quantity of advanced age population in our country,the morbidity rate of advanced age patients with intestinal obstruction becomes more and more higher.Advanced age intestinal obstruction has the following characteristics:higher stealthiness,complicated pathogenesis and faster progress.In addition,advanced age patients always has a organ function degeneration,poor body resistance and concurrent basic diseases.So there are increased the difficulties of diagnosis and treatment in the advanced age patients with intestinal obstruction.Therefore,the cause of intestinal obstruction in advanced aged patients,disease progression and treatment options have become difficult problems that clinicians workers must face directly.Objective:To investigate the diagnosis,etiology and treatment of advanced age patients with intestinal obstruction.In order to provide reference for the diagnosis and treatment of the advanced age obstruction.Methods: The type of obstruction,obstruction etiology and treatment methods of 103 advanced age patients with intestinal obstruction,admitted to our department,were collected from August 2012 to August 2015 were summarized.Comprehensive analysis of the influence on treatment effect by these factors,such as the position of obstruction,treatment form and concurrent basic diseases.Results:(1)One hundred and three cases were researched in this article,in which there were 56 males and 47 females.There was no gender gap in the distribution in different causes in advanced age obstruction patients.Among them,mechanical intestinal obstruction was in 83 cases(80.58%),in dynamic ileus 9 cases(8.74%),blood supply ileus in 3 patients(2.91%)and unexplained ileus in 8 cases(7.77%).There were 42 cases(50.60%)with malignant tumors of the patients with mechanical obstruction,20 cases(24.10%)with adhesions,14 cases(16.87%)with fecal,4 cases(4.82%)with volvulus,2 cases with incarcerated hernia(2.41 %),one case with intussusception(1.20%).Among 42 cases of tumors,there were two cases of intestinal obstruction with small bowel tumors(4.76%),12 cases with right colon tumors(28.57%),28 cases with left colon and rectal tumors(66.67%).Among 20 cases of intestinal obstruction patients,there were 16 cases(80%)with the history of abdominal surgery,4 cases with the intra-abdominal inflammation or infection history.(2)In non-neoplastic obstruction of non-surgical treatment patients,those used ileus tube decompression,compared with the patients used gastric tube decompression the time,such as recovery time of bowel function,obstructive symptom relief time and the average hospital stay time,were significantly reduced(p <0.05).In patients with malignant tumor obstruction,compared with non-surgical treatment,surgery significantly increased the treatment efficiency(p <0.05).In tumor obstruction patients,the times which include the bowel function recovery,obstructive symptom relief time and the average hospital stay time,had no difference between different parts of the obstruction(p >0.05).(3)There were 80 cases of advanced age patients with ileus associated with concurrent diseases.The patients in non-neoplastic ileus patients without concurrent diseases,compared with those associated with concurrent diseases,the patient's recovery time of bowel function,obstructive symptom relief time and the average hospital stay time were significantly shorter(p <0.05).Compared with the patients with concurrent diseases,the postoperative complications in the patients without concurrent diseases were decreased(p <0.05).Conclusions:(1)The major cause of advanced age intestinal obstruction was malignant neoplasm,followed by adhesions and fecal.(2)Ileus tube decompression was better than gastric tube decompression.(3)Among advanced age patients with intestinal obstruction caused by the malignant tumor,the tumor occured mainly in the left colon and the rectum.There was no relationship between tumor site and the efficacy of surgical treatment.(4)The concurrent disease affected the efficacy of advanced age patients with ileus.(5)The age was not the determining factor for the treatment method in advanced age patients with ileus.(6)Surgery should be chosen as the main treatment mode in advanced age patients with ileus caused by tumors,when general condition of the patient was allowed.