郝小峰

【摘  要】目的 探讨肠道肿瘤所致老年性肠梗阻的外科治疗。方法 对本院收治的173例肠梗阻病人中108例肠道肿瘤病人进行回顾性研究。结果 99例行手术治疗，6例小肠肿瘤均行一期肿瘤切除肠吻合术;65例结肠肿瘤，62例行手术中扩张肠管减压一期肿瘤切除肠吻合术;3例行一期切除左半结肠，Hartmann结肠造口术，3～4个月行闭瘘手术;37例上段直肠癌，9例因肿瘤无法切除行乙状结肠造瘘术，12例行Milles术式，两例行Dixon术式。5例行Hartmnn术式。肿瘤切除率83%（90/108）。45例术后出现不同程度并发症，占手术病人的45%（45/99）。切口感染28例，肠瘘3例，肺部感染10例，再发肠梗阻4例。结论 在肠道肿瘤所致老年性肠梗阻病人的外科治疗中以切除肿瘤，解除梗阻，延长寿命，提高生存质量为目的。

【关键词】肠道肿瘤;老年;肠梗阻 ;治疗

【中图分类号】R198      【文献标识码】A      【文章编号】1004-7484（2019）07-0132-01

【Abstract】Objective to explore age-related intestinal obstruction caused by tumors of the surgical treatment.Methods of the 173 patients treated in our hospital patients， 108 cases of intestinal obstruction intestinal cancer patients were studied retrospectively.Results 99 cases with surgical treatment， 6 patients underwent a small intestinal tumor resection intestinal anastomosis; 65 cases of colon cancer， 62 cases with surgical decompression in the expansion of a bowel tumor resection intestinal anastomosis; 3 routine 1 left colon resection， Hartmann colostomy， 3 ～ 4 months line closed fistula surgery; 37 patients with upper rectal cancer， 9 cases of cancer can not be removed because of PEG-line sigmoid colon， 12 cases underwent surgical Milles， two routine Dixon surgical. 5 Regular Hartmnn surgical. Tumor resection rate 83% （90/108）. 45 cases of postoperative complications of different degrees， accounting for 45% of surgical patients （45/99）. Wound infection in 28 cases of intestinal fistula in 3 cases， pulmonary infection in 10 cases of recurrent intestinal obstruction in 4 cases. Conclusion In the age-related intestinal obstruction caused by intestinal tumor in the surgical treatment of patients with tumor resection to relieve obstruction， prolonging life， improving the quality of life for the purpose

【Key words】 Intestinal tumor Elderly  Obstruction Treatment

我院自 2010-2019年間共收治50岁以上肠梗阻病人143例，其中肠道肿瘤病人108例占75.59%（108/143），现总结报告如下：

1 对象与方法

1.1 一般资料 本组男73例，女35例，年龄50-81岁，平均年龄：67.7岁。其中结肠肿瘤65例，直肠肿瘤37例，小肠肿瘤6例。

1.2 临床表现 急性肠梗阻54例，慢性梗阻89例。腹部包块28例，大便性状（主要为腹胀、便秘）改变32例，大便带血27例，慢性阑尾炎表现19例。

1.3 诊断 入院确诊69例，院前误诊为慢性阑尾炎6例，习惯性便秘15例，18例以腹痛待查收住入院。

1.4 治疗 除9例经CT检查证实肿瘤广泛转移，全身衰竭及其他严重疾病而放弃手术。余99例行手术治疗，其中急诊手术42例，限期手术57例。6例小肠肿瘤均行一期肿瘤切除肠吻合术……