Analysis of the Application Effects and Prognostic Factors of Surgery and Conservative Treatment in Elderly Patients with Malignant Tumor-Related Acute Intestinal Obstruction
WANG Hongfang, LI Peiman, GENG Peng
Department of Surgery, Luohe Central Hospital of Traditional Chinese Medicine, Luohe Henan 462000
Abstract：【Objective】To investigate the effects of surgery and conservative treatment in elderly patients with malignant tumor-related acute intestinal obstruction and to analyze the factors influencing prognosis. 【Methods】A retrospective analysis was conducted on the medical records of 96 elderly patients with acute intestinal obstruction admitted to our hospital. Among them, 71 patients were treated with bowel resection and anastomosis, stoma creation, or bowel exteriorization based on their condition, while 25 patients received conservative treatment such as gastrointestinal decompression. The patients were divided into a good prognosis group (79 cases) and a poor prognosis group (17 cases) based on the prognosis two months after treatment. The factors influencing prognosis were analyzed. 【Results】The treatment success rate was 94.37%(67/71) in the surgery group, which was higher than the 48.00%(12/25) in the non-surgery group (P<0.05). There was no statistically significant difference in the overall incidence of postoperative complications between the two groups (P>0.05). The poor prognosis group had higher proportions of pathological stage Ⅲ, low differentiation of tumors, and older age compared to the good prognosis group (P<0.05). Logistic multivariate regression analysis showed that age, pathological stage, and tumor differentiation degree were factors influencing prognosis (P<0.05). 【Conclusion】Compared to non-surgical treatment, surgical treatment is more effective in alleviating symptoms of intestinal obstruction in elderly patients with malignant tumor-related acute intestinal obstruction. Factors such as patient age, pathological stage, and tumor differentiation degree can influence prognosis.
王红芳, 李培满, 耿鹏. 手术与保守治疗在高龄恶性肿瘤相关性急性肠梗阻中的应用效果及预后影响因素分析[J]. 医学临床研究, 2024, 41(7): 998-1000.
WANG Hongfang, LI Peiman, GENG Peng. Analysis of the Application Effects and Prognostic Factors of Surgery and Conservative Treatment in Elderly Patients with Malignant Tumor-Related Acute Intestinal Obstruction. JOURNAL OF CLINICAL RESEARCH, 2024, 41(7): 998-1000.
[1] 张筱国,孙晓光,杨剑,等. 不同手术方式治疗结肠癌并急性肠梗阻的疗效分析[J].贵州医药,2017,41(11):1174-1176. [2] 王健,刘静,李成刚,等. 腹腔镜与开腹手术治疗直肠癌术后早期肠梗阻的疗效分析[J].医学与哲学,2016,37(22):24-26. [3] BOOK T, KIRSTEIN M M, SCHNEIDER A, et al. Endoscopic decompression of acute intestinal distension is associated with reduced mortality in critically ill patients[J].BMC Gas,2020,20(1):87. [4] 刘洋. 老年结肠癌并肠梗阻手术治疗方法及效果分析[J].国际老年医学杂志,2016,37(1):27-29. [5] 叶任高.内科学[M].6版.北京:人民卫生出版社, 2003: 358-364. [6] 刘杨,王刚成,刘英俊,等. 宫颈癌根治性放疗后复发并肠梗阻高危体质患者的手术理念及技巧[J].中华肿瘤杂志,2020,42(1):61-64. [7] 冯海洋,刘卓,翟瑾洁,等. 次全结肠切除术与Ⅱ期手术治疗左半结肠癌伴急性肠梗阻的疗效比较分析[J].浙江临床医学,2018,20(12):1922-1924. [8] 赵海荣,魏强,鲁海洋,等. 左侧结肠癌并发急性肠梗阻根治手术的方法及疗效分析[J].实用癌症杂志,2017,32(10):1722-1724. [9] 李泽平. 结肠癌急性肠梗阻患者117例手术疗效分析[J].实用医院临床杂志,2016,13(3):121-122. [10] TOLEDO J J, CORREIA M M, COUTINHO R R, et al. Perforation of the cecum resulting from a closed-loop obstruction in a patient with an adenocarcinoma of the sigmoid colon: a case report[J].Int J Surg Case Rep,2017,36(4):143-146. [11] 冯以斌,别玉坤. 手术治疗老年结直肠癌患者急性肠梗阻的疗效[J].中国肿瘤临床与康复,2016,23(1):79-81. [12] 吴秋明,吕俊生,林秋疃,等. 结肠癌合并肠梗阻老年患者外科手术治疗预后的影响因素分析[J].癌症进展,2019,17(22):2702-2705. [13] 张海鹏. 结肠癌合并肠梗阻手术治疗45例[J].陕西医学杂志,2016,45(3):340-341. [14] 郝治,龚海峰,甄宏博. 结直肠癌腹腔镜手术患者术后肠梗阻发生率及影响因素分析[J].中国肿瘤外科杂志,2019,11(6):453-456.
2024, Vol. 41 
