| Objective: To investigate the incidence,causes,clinical features and post-treatment mortality of patients with intestinal obstruction in Abdominal Emergency Department of the First Affiliated Hospital of Dalian Medical University in recent 5 years.Methods: In our hospital from January 2011 to December 2016,672 cases of intestinal obstruction were collected,the diagnose of which was according to the definition of intestinal obstruction in the eighth edition of the People's Education Press,the history,clinical manifestation and signs,auxiliary examination and intraoperative findings and other aspects.Record the clinical data of patients with intestinal obstruction,including general information(age,gender,previous surgical history,etc.),pathogenesis,treatment,prognosis and so on.All patients need to meet: age ? 15 years old,men and women are not limited;received treatment in our hospital from the department of Acute abdomen surgery;discharge was diagnosis "intestinal obstruction." Statistical analysis was performed using SPSS20.0 software.The data were described as mean ± standard deviation.The count data were described by the number of cases and percentage.The chi-square test was used to compare the symptoms between groups.Statistical analysis P <0.05 stands for meaning.Result:(1)In all patients,543 cases of mechanical obstruction(80.8%),16 cases(2.4%)of dynamic intestinal obstruction,7 cases(1.0%)of blood-induced intestinal obstruction,106 cases of unknow(15.8%).(2)There were 287 cases in the middle-age group,159 cases of adhensive intestinal obstruction(55.2%);48 cases of tumor intestinal obstruction(15.6%);8 cases of bowel twist(2.8%).While in the elderly group,172 cases of adhensive IO(43.5%);99 cases of tumor IO(25.0%),14 cases of hernia(3.5%)and bowl twist(3.5%),adhensive IO in the middle-aged group,accounted for 55.2% and 43.5% in the elderly group,there was significant difference between them(P> 0.05).The tumor factors accounted for 55.2% in the elderly group and 15.6% in the middle-aged group,the difference was significant(P <0.05).There was no significant in other factors such as hernia,paralysis,fecal stone and intestinal torsion.(3)Of all the patients 395 cases underwent abdominal surgery(58.8%,395/672);331 cases of adhesive intestinal obstruction,of which 268 cases(81%,268/331)had abdominal surgery history Accounting for 67.8%(268/395)of all patients who had surgery,133 cases of middle-aged group and 135 cases of elderly group.Among them,the first place was adhesions due to appendectomy,accounting for 71 cases(26.5%),followed by intestinal and gastroduodenal surgery,respectively,49,48 cases,accounting for 18.3% and 17.9%;Gynecological surgery in 45 cases,accounting for 16.8%;biliary surgery in 18 cases(6.7%).The other 34 cases(12.7%).(4)There were 258 patients with adhesions,the mortality rate was 1.9%(5/252);73 cases were treated with surgery,the mortality rate was 2.7%(2/73),the total mortality rate was 21%(7/331);the overall mortality rate was 12.5%(18/144)in patients with neoplastic causes,with a conservative mortality rate of 11.8%(13/110)and a surgical mortality rate of 14%.7%(5/34);other causes of intestinal obstruction,the mortality rate of 4.7%(5/106),which conservative treatment mortality rate of 4.7%(3/64),The surgical treatment mortality rate of 9.5%(2/42).Conclusion: 1.The most common cause of intestinal obstruction is intestinal adhesions(including surgery,inflammation,etc.),followed by tumor factors.2.Adhesive bowel obstruction is more common in young patients(<60 years),especially in patients ever underwent abdominal surgery.3.For non-surgical history of elderly patients with intestinal obstruction,tumor factors often account for the main position.4.Most patients with intestinal obstruction can relieve only by conservative treatment. |
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