直肠癌Miles术后并发内疝性肠梗阻的防治(附5例报告)  

The prevention,diagnosis and treatment of intestinal obstruction induced by internal hernia after Miles' operation

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

机构地区：[1]广东省中山市中医院普通外科,528400

出　　处：《结直肠肛门外科》2007年第6期360-361,共2页Journal of Colorectal & Anal Surgery

摘　　要：目的:探讨直肠癌Miles术后内疝性肠梗阻的原因、预防和诊治。方法:对1998年1月至2006年10月间收治的直肠癌Miles术后并发内疝性肠梗阻5例进行回顾性分析。结果:Miles术后并发内疝性肠梗阻的发生率为6%(5/82),表现术后不同程度的腹胀,阵发性腹痛,呕吐,胃管引流液每天超过500 mL者,结肠造瘘口无排气排便;腹部轻压痛,肠鸣音活跃或亢进。腹部立、卧位X线片检查,均发现肠腔扩张、多个液平或孤立性肠袢扩张。5例均行剖腹探查而证实,疝内容物为回肠,其中行单纯粘连松解复位2例,部分回肠切除、端端吻合术3例。再次手术后均痊愈出院。结论:Miles术后内疝性肠梗阻常缺乏典型的临床表现,早期诊断和及时剖腹探查是处理的关键,其重点在于预防。Objective: To approach the causes,prevention methods,diagnosis and treatment of intestinal obstruction induced by internal hernia after Miles' operation.Methods: The clinical data of 5 cases of intestinal obstruction induced by internal hernia after Miles' operation from January 1998 to October 2006 were retrospectively analyzed.Results: The incidence rate of intestinal obstruction induced by internal hernia after Miles' operation was 6%(5/82).The hernia contents of all the 5 cases were ileum confirmed by operation.Two cases accepted enterolysis,and three cases accepted enterectomy.All the cases were healing.Conclusion: Intestinal obstruction induced by internal hernia after Miles' operation is usually short of typical clinical manifestation.The key point of treatment is early diagnosis and having exploratory laparotomy in time.

关 键 词：直肠肿瘤 内疝性肠梗阻 预防 诊断 治疗 

分 类 号：R735.37[医药卫生—肿瘤]