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目的探讨老年急腹症的临床特点及诊治体会。方法将老年急腹症与青壮年急腹症临床特点比较分析,并分析老年急腹症治疗方法及结果。结果老年急腹症组出现精神意识障碍、电解质混乱、白蛋白降低、休克或休克前期者比例明显高于青壮年组,腹部压痛、肌紧张或反跳痛比例明显低于于青壮年组,差异有统计学意义(P<0.05);两组患者在肠鸣音减弱或消失、肛门停止排气排便、腹腔积液、白细胞≥10×109/L、体温>37.3℃者的比例方面比较差异无统计学意义(P>0.05)。53例手术治疗,手术成功者49例,死亡4例。结论老年急腹症表现不典型具有其临床特殊性,外科医生必需重视。正确合理处理围手术期,谨慎的麻醉、简单的术式及术后管理,可以取得较好的预后。
Objective To investigate the clinical features and diagnosis and treatment of senile acute abdomen. Methods The clinical features of acute abdomen and young adult acute abdomen were compared and analyzed. The treatment methods and results of senile acute abdomen were analyzed. Results The elderly patients with acute abdomen had mental disorders, electrolyte disturbance, decreased albumin, the proportion of shock or shock in the early stage was significantly higher than that of the young and middle-aged patients. The rates of abdominal tenderness, muscle tension or rebound pain were significantly lower than those of the young and middle-aged adults (P <0.05). There was no significant difference between the two groups in the proportion of patients with weaning or disappearance of bowel sounds, anal defecation, ascites, white blood cells≥10 × 109 / L and body temperature> 37.3 ℃ Statistical significance (P> 0.05). 53 cases of surgical treatment, 49 cases of successful surgery, 4 patients died. Conclusion Atypical elderly patients with atypical acute clinical features, surgeons must pay attention to. Correct and reasonable perioperative management, careful anesthesia, simple surgical procedures and management, you can get a better prognosis.