超高龄急性腹膜炎的诊断与治疗

目的探讨80岁以上超高龄包性腹膜炎的临床特点及治疗策略。方法收集近十年来35例80岁以上超高龄急性膜炎手术治疗的临床资料,进行加顾性分析。结果 80岁以上超高龄急性腹膜炎的原发病以胆石症为最多(占54.3%),次之是上消化道穿孔(占25.7%)。伴有并存病多;伴有一种并存病(占22.9%),二种并存病(占46.8%),三种以上产存病(占37.1%)。全组手术死亡2例(占5.7%)。结论 80岁以上超高龄急性腹膜炎的特点是病理改变重且快,临床征象轻,容易发展成感染中毒性休克,宜作简单的检查诊断,尽早手术检查。

The diagnosis and treatment of acute peritonitis in patients with advanced age

Objective To discuss the clinical characteristics and treatment policy of acute peritonitis in patients over 80 years of age.Methods The clinical data of 35 pa- tients over 80 years of age with acute peritonitis were studied retrospectively,they were treat- ed with operation in the past 10 years and the data were analyzed by regression.Results the most freguent primary affection in these patients was cholelithiasis(19/35)and the next was upper alimentary perforation25.7%(9/35).There were more complications due to acate peritonitis in these patients of advanced age.Among them,8(22.9%)had one cimplication, 17(46.8%)had two complications and 13(37.1%)had three or more than three complica- tions.There were two fatal cases in these patients(5.7%).Conclusions The characteris- tics of lacute peritonitis in these patients over 80 years of age are severe pathological change, mild clinical sign and liability to suffer from septic shock.For these patients,it is essential to make eorrect diagnosis in time and perform the operation as soon as possible.