手术治疗老年上消化道穿孔的临床效果分析

目的：探讨并分析治疗老年上消化道穿孔的手术方法及其影响因素。方法：收集整理我院2012年1月至2013年1月收治的35例老年上消化道穿孔患者的临床资料，根据患者病情，选择合适的术式对全部患者给予手术治疗，对合并症患者给予积极的对应处理。结果：本组患者术中可见穿孔平均直径（1．7±0．2）cm，腹腔平均积液（2100±200）mL，积液均为混浊或脓性液。术后1例患者死亡，8例患者出现并发症。根据患者的临床因素对术后并发症的发生情况进行比对，我们发现：患者的年龄较大、合并症越复杂、接受手术的时间越迟，那么术后患者发生并发症的机率则越高。结论：采取手术治疗老年上消化道穿孔应充分考虑老年患者特殊的临床因素对其疗效及预后的影响，以安全、简单、有效为基本原则，选择适合病患实际病情的最佳术式，进一步提高手术成功率和临床疗效。

Analysis of the Clinical Efficacy of Surgery on Elderly Patients with Upper Gastrointestinal Perforation

Objective： To investigate and analyze the operative methods for elderly patients with upper gastrointestinal perforation and the influence factors. Methods： The clinical data of 35 patients who were diagnosed as upper gastrointestinal perforation in our hospital from 2012 January to 2013 January were collected. All the selected patients were given the suitable surgical treatment on the basis of patient＇s clinical factors. As for the patients with complications, we have made corresponce to active treatment. Results： The average perforation diameter and abdominal effusion of all the patients was seen in visible with （1.7 ± 0.2） cm and （2100 ± 200） mL respectively, and the effusion presented to be cloudy or purulent fluid. There was one case died and eight cases reflected complications after the operation. According to the clinical factors of patients, we analyzed the situations of postoperative complications. Then we found that the incidence of postoperative complications were prone to be caused when the patients were older, more complications, or later for surgical resection. Conclusions： We should pay more attention to the special clinical factors of elderly patients with clinical therapeutic effect and prognosis when conducting surgical treatment. We＇d better select the most proper operative methods on the principle of efficacy, easy and safety so as to improve the clinical efficacy.