Alvarez Pérez José A, Baldonedo Ricardo F, Bear Isabel G, Solís José A S, Alvarez Paloma, Jorge José I
Department of General Surgery, Hospital San Agustin, Avilés, Spain.
Int Surg. 2003 Oct-Dec;88(4):231-7.
The aim of this study was to determine the clinical presentation, morbidity, and mortality and to identify the factors that might affect the outcome of emergency repair in elderly patients. A study of 143 patients (> 65 years old) who underwent emergency surgical repair for incarcerated external hernias during the period 1992-2001 was done. Fifty patients (35%) presented after 48 hours of symptoms onset. Coexisting diseases were found in 104 cases (77.7%). Bowel resection was required in 25 patients (17.5%). Overall morbidity was 46.2%, and major complications were seen in 17 cases (11.9%). Mortality was observed in seven patients (4.9%). Longer duration of symptoms, delayed hospitalization, concomitant illness, and high American Society of Anesthesiologists scores were significant factors linked with unfavorable outcome. To avoid the increased risks of emergency hernia repairs in the elderly, priority admission and early elective surgery should be used.
本研究的目的是确定临床表现、发病率和死亡率，并找出可能影响老年患者急诊修补手术结果的因素。对1992年至2001年期间因嵌顿性外疝接受急诊手术修补的143例患者（年龄>65岁）进行了研究。50例患者（35%）在症状出现48小时后就诊。104例患者（77.7%）存在合并症。25例患者（17.5%）需要进行肠切除。总体发病率为46.2%，17例患者（11.9%）出现严重并发症。7例患者（4.9%）死亡。症状持续时间较长、延迟住院、合并症以及美国麻醉医师协会评分较高是与不良预后相关的重要因素。为避免老年患者急诊疝修补手术风险增加，应采用优先入院和早期择期手术。
