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目的探讨老年人结直肠癌穿孔的特点、诊断方法、术式选择及疗效和进一步提高诊治水平的措施。方法回顾性分析我院53例老年人结直肠癌穿孔患者的临床资料。结果术前明确诊断20例(37.7%)。行右半结肠癌根治性切除I期肠吻合术20例;行左半结直肠癌I期根治切除,Hartmann造口术26例;姑息性结直肠癌切除术+近端结肠造口+远端关闭术5例,单纯修补穿孔+近端结肠双腔造瘘术2例。围术期死亡9例(13.2%),44例治愈或好转。结论老年人结直肠癌合并穿孔病死率较高,误诊率较高,并发症多,要详细地采集病史、进行严格的体格检查和分析辅助检查结果,制定个体化诊疗方案,及时手术、选择合理的手术方式可减少病死率,提高生活质量。
Objective To explore the characteristics of colorectal cancer perforation, diagnosis, surgical options and efficacy and to further improve the diagnosis and treatment of colorectal cancer. Methods The clinical data of 53 elderly patients with colorectal cancer perforation were retrospectively analyzed. Results 20 cases were diagnosed preoperatively (37.7%). The right colon resection of colon cancer Ⅰ I anastomosis in 20 cases; I left stage radical resection of colorectal cancer, Hartmann ostomy in 26 cases; palliative colorectal resection + proximal colostomy + distal Close surgery in 5 cases, simple repair perforation + proximal colon two-chamber ostomy in 2 cases. Perioperative deaths in 9 cases (13.2%), 44 cases of cure or improvement. Conclusion The colorectal cancer patients with high perforation mortality, high misdiagnosis rate and many complications, the elderly should be carefully collected history, rigorous physical examination and analysis of auxiliary examination results, develop individualized diagnosis and treatment programs, timely surgery, choose a reasonable The surgical approach can reduce mortality and improve quality of life.