急性非外伤性结肠穿孔诊治体会  

The Experience of Diagnose and Treatment about Acute Nontraumatic Colonic Perforation

作　　者：李建明[1] 陈海生[1] 刘学强[1] 严志登[1] 万恒荣[1] 

机构地区：[1]广东省中山市中医院外科,528400

出　　处：《岭南急诊医学杂志》2007年第4期275-276,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨急性非外伤性结肠穿孔的病因、诊断及治疗。方法:回顾性分析15例急性非外伤性结肠穿孔病例的处理。结果:穿孔原因为癌性穿孔7例,缺血性穿孔2例,溃疡性结肠炎2例,穿孔原因不明4例。术前2例考虑为左半结肠穿孔。右半结肠穿孔病例采用病灶切除一期吻合,左半结肠穿孔病例采用Hartmann手术为主,3例死亡病例手术时间距起病都超过24小时。结论:急性非外伤性结肠穿孔以肿瘤最多见;本病术前诊断较困难;早诊断、早治疗是提高急性非外伤性结肠穿孔抢救成功率的主要措施。Objective: To approach the etiological factor, diagnosis and treatment of acute nontraumatic colonic perforation. Methods: we retrospective analyzed the management of 15 cases of acute nontraumatic colonic perforation. Results: There were 7 cases of carcinomatous perforation, 2 cases of ischemic perforation, 2 cases of colitis gravis, and 4 cases of unknown origin. There were 2 cases were considered as left hemicolon perforation before operation. All the right hemicolon perforation were treated with focal excision and primary enteroanastomosis. All the left hemicolon perforation were treated with Hartmann's modus operandi. The time between oncet and operation of 3 died cases all weeded more than 24 hours. Conclusion: Most of the etiological factors of acute nontraumatic colonic perforation were tumour. It was very hard to diagnose this disease before operation. To increase the treating achievement ratio, early diagnosis and early treatment were very important.

关 键 词：结肠穿孔 手术 

分 类 号：R656.9[医药卫生—外科学]