成人肠梗阻的病因和临床结局与病人年龄的关系研究

发布时间：2018-06-10 02:10

本文选题：肠梗阻 + 病人年龄　；参考：《青岛大学》2015年硕士论文

【摘要】：目的:探讨不同病因在各年龄组肠梗阻患者中的分布情况及肠梗阻的治疗方式、临床结局与患者年龄的关系。方法:回顾分析青岛大学附属医院急诊普外科2008年1月至2013年12月住院治疗的500例诊断为肠梗阻患者的资料。按年龄分为青年组、中年组、年轻老年组、老年组。统计各年龄组患者肠梗阻的病因、治疗方式、住院天数、并发症及病死率。采用SPSS 17.0统计软件对数据进行分析。结果:500例肠梗阻病例中,青年组58例,中年组139例,年轻老年组170例,老年组133例,各年龄组构成比差异有显著意义(P0.01)。前5位的病因是肠粘连、肿瘤、粪石、嵌顿疝、肠套叠。青年组、中年组及年轻老年组病例中,首位病因均为粘连,老年组病例中首位病因为肿瘤。青年组与年轻老年组、青年组与老年组病因构成比比较差异均有显著意义(P0.05),其他各年龄组病因构成比两两比较差异均无显著意义(P0.05)。各年龄组中保守治疗患者住院天数均短于手术治疗患者住院天数,且差异均有显著意义(P0.01)。保守治疗方式病例,青年组、中年组住院天数比较差异无显著意义(P0.05);其它各年龄组住院天数两两比较差异均有显著意义(P0.05)。手术治疗方式病例,青年组与中年组、年轻老年组与老年组住院天数比较差异均无显著意义(P0.05);其它各年龄组住院天数两两比较差异均有显著意义(P0.05)。青年组、中年组、年轻老年组、老年组中手术治疗率分别有46.55%、56.12%、55.29%、64.66%,四组两两比较仅青年组与老年组之间差异有显著意义(P0.05),其余均无显著性差异(P0.05)。青年组、中年组、年轻老年组、老年组分别有20.69%、32.37%、51.76%、61.65%存在合并症,四组两两比较青年组与中年组、年轻老年组与老年组之间差异无显著意义(P0.05),其余均存在显著性差异(P0.05)。青年组中年组、年轻老年组、老年组各年龄组病死率分别为0%、0.7%、2.35%、4.51%,四组两两比较仅中年组与老年组之间差异有显著意义(P0.05),其余均无显著性差异(P0.05)。相关性分析示肠梗阻患者的住院天数、手术率、并发症率、死亡率均与患者的年龄呈正相关,有随年龄增大而增加的趋势(P0.05)。结论:1.肠梗阻患者中各年龄组病例构成比不同;青年组最少。2.不同年龄组患者肠梗阻的病因构成比相差很大,肿瘤、粘连和粪石成为肠梗阻的三大病因,老年的首位病因是肿瘤,青年及中年、年轻老年的首位病因是肠粘连。3.不同年龄组肠梗阻患者的治疗方式及临床结局存在差异。4.肠梗阻患者的住院天数、手术率、合并症率、死亡率均与患者的年龄呈正相关。
[Abstract]:Objective: to investigate the distribution of different etiology in patients with intestinal obstruction in different age groups and the relationship between clinical outcome and age. Methods: the data of 500 patients with intestinal obstruction diagnosed in emergency department of general surgery from January 2008 to December 2013 were retrospectively analyzed. According to age, they were divided into youth group, middle age group, young old group and old group. The etiology, treatment, hospital stay, complications and mortality of intestinal obstruction in all age groups were analyzed. SPSS 17.0 statistical software was used to analyze the data. Results among 500 cases of intestinal obstruction, 58 cases were in the young group, 139 cases in the middle age group, 170 cases in the young group and 133 cases in the elderly group. The top 5 causes are intestinal adhesion, tumor, fecal stone, incarcerated hernia, intussusception. Adhesion was the first cause in the young, middle aged and young aged patients, and tumor was the first cause in the elderly. There was significant difference between the young group and the young group, the young group and the old group in the etiological composition ratio (P 0.05), but there was no significant difference in the other age groups in the etiological composition ratio between the young group and the young group (P 0.05%), the young group (P 0.05) and the old group (P 0.05). The days of hospitalization of patients with conservative treatment in all age groups were shorter than those of patients treated with surgery, and the difference was significant (P 0.01). There was no significant difference in the days of hospitalization between the young group and the middle age group, but there was no significant difference in the length of stay in other age groups (P 0.05). There was no significant difference in the length of hospitalization between the young group and the middle age group, the young group and the old group, but there was no significant difference in the length of hospitalization between the other age groups (P 0.05). In the young group, the middle age group, the young old group and the old group, the rate of surgical treatment was 46.55 and 55.29 and 64.66, respectively. The difference between the four groups was only significant (P0.05) between the young group and the old group, but there was no significant difference between the other groups (P0.05). There were 61.65% complications in young group, middle age group, young old group and old group, respectively. There were no significant differences between young group and middle age group in four groups, and there was no significant difference between young group and old group (P 0.05), while there was significant difference in other groups (P 0.05%). The fatality rate of young group, young group and old group were 0, 0, 0, 0, 0, 0, 0, 0, 0 and 0. 5, respectively. The difference between the four groups was only significant (P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05) respectively. The correlation analysis showed that the days of hospitalization, the rate of operation, the rate of complications and the death rate of patients with intestinal obstruction were all positively correlated with the age of the patients, and there was a tendency to increase with the increase of age (P 0.05). Conclusion 1. The proportion of cases in each age group was different in the patients with intestinal obstruction, and the lowest in the young group. The proportion of the causes of intestinal obstruction in different age groups is very different. Tumor, adhesion and fecal stone become the three major causes of intestinal obstruction, the first cause of old age is tumor, the first cause of youth and middle age, and the first cause of young and old age is intestinal adhesion. The treatment and clinical outcome of patients with intestinal obstruction in different age groups were different. 4. 4. The days of hospitalization, the rate of operation, the rate of complications and the death rate of patients with intestinal obstruction were positively correlated with the age of the patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.7

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