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題名 | 老年人腹部手術百例分析--特別著重危險因子探討 |
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作者 | 李威傑; | 書刊名 | 慈濟醫學 |
卷期 | 3:1 1991.03[民80.03] |
頁次 | 頁1-6 |
分類號 | 417.7 |
關鍵詞 | 老年人腹部手術; 危險因子; |
語文 | 中文(Chinese) |
中文摘要 | 民國76年7月至78年9月間,本院共有100例70歲以上老年人接受腹部手 術,佔同期間腹部手術者之9.7。男與女之比為61比39,平均年齡為75.3歲,年齡 分布由70歲至94歲,其中有18位年齡超過80歲。手術疾患以膽囊及膽道手術30例 居首位,其次為消化管惡性腫瘤28例,包括胃癌14例,小腸惡性腫瘤2例,大腸 癌12例。消化性潰瘍之併發症有23例,包括穿孔14例,出血8例,狹窄1例。闌尾 炎則有12例。手術死亡率為17,死亡原因分別以肺部合併症6例 ,心臟血管合併 症5例及敗血症4例為多。危險因子的分析上,僅是否合併有內科問題者有意義 (28.3V.S7.4),其餘超高齡,急診手術,全身麻醉,惡性疾病雖然有2到3倍的百分 比差距,卻不具統計學上的意義。(慈濟醫學1991;3:1-6) |
英文摘要 | A retrospective study of 100 patients aged over 70 received laparotomy from July, 1987 to Sep, 1989 at LoTung Poh-Ai Hospital was conducted. There were 61 males and 39 females. The age distributed from 70 to 94with 18 patients over 80. The mean age was 75.3. There were 30 cases of gall bladder and biliary tree diseases,28 cases of gastro-intestinal malignancy, which included 14 cases of gastric cancer, 2 cases of small intestinalmalignancy and 12 cases of colon cancer. There were 23 cases of complication of peptic ulcer disease, including 14 cases perforation, 8 cases of bleeding and I stenosis. Only 12 cases were appendicitis as compared toover half cases in general population. The operation mortality was 17 (17 cases), with the leading causes of pulmonary complication (6 cases),cardiovascular accident (5 cases) and septic complication (4 cases). The most dangerous period was the first 48hours immediately after operation as cardiovascular accident and septic shock occured. The pulmonary complication caused mortality usually after a week. The only significant risk factor of operation mortality was whetherassociated with major medical problem or not (28.4 vs 7.4). Other factors such as superold aged (≧ 80),emergency operation, general anesthesia, malignant disease, although carried with 2 to 3 times of risk, wee notsignificant statistically. (Tz'u-Chi Med J 1991; 3: 1-6) |
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