ObjectiveTo summarize the various treatment methods for reducing jaundice in the elderly patients with malignant obstructive jaundice (MOJ), and provide reference for the treatment of elderly MOJ.MethodUsing “malignant obstructive jaundice” as the Chinese keyword and the English keyword, a computer search of the literatures on the treatment of elderly MOJ patients was conducted and reviewed.ResultsThe treatment methods of reducing jaundice in elderly MOJ included radical surgery, cholangiojejunostomy, endoscopic ultrasound-guided biliary drainage, endoscopic biliary stent implantation, percutaneous transhepatic biliary drainage and stent implantation. Radical surgery was the most effective, but it was traumatic and had many complications for elderly patients. Cholangiojejunostomy was effective and suitable for elderly patients who cannot tolerate major surgery. Endoscopic ultrasound-guided biliary drainage was less traumatic to elderly patients, but technical difficulty. Endoscopic biliary stent implantation was currently the first-line choice for the treatment of elderly patients with advanced MOJ. Percutaneous transhepatic biliary drainage and stent implantation were suitable for elderly and frail patients with high obstruction.ConclusionThe treatment of elderly MOJ needs to be individualized and regionalized, and appropriate treatment methods should be selected according to the patient’s condition and the medical level of the medical center.
目的 探讨腹主动脉瘤破裂的诊断和治疗方法。方法 我院从1999年10月至2004年1月期间经手术治疗腹主动脉瘤破裂6例。结果 1例患者因术后失血性休克而死亡； 5例患者随访4年，1例术后2年死于心肌梗死，余4例存活。结论 腹主动脉瘤应早期诊断、早期治疗，一旦破裂应迅速诊断、急诊手术，手术时应注意阻断腹主动脉的方法以及防止术后下肢缺血。