结直肠损伤的诊断和外科治疗  

The diagnosis and surgical management of colorectal injuries

作　　者：马森[1] 王利民[1] 林群[1] 

机构地区：[1]深圳市坪山人民医院外二科,广东深圳518118

出　　处：《中国基层医药》2005年第4期425-426,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨结直肠损伤的诊断和外科治疗方法。方法　回顾性分析5 2例结直肠损伤患者的临床资料。结果　31例(5 9 6 2 % )急诊剖腹探查明确诊断。一期肠修补或切除吻合术39例(75 % ) ,二期肠造口或肠外置术13例(2 5 % )。发生肠瘘2例,死亡5例。死亡原因为多发伤、出血性休克、严重感染与多脏器功能衰竭。结论　剖腹探查是诊断结直肠损伤的重要手段,手术治疗方式的选择主要取决于结直肠损伤程度、腹腔污染情况及患者的全身情况。Objective To evaluate the diagnosis and surgical management for colorectal injuries.Methods The clinical data of 52 patients with colorectal injuries were analyzed retrospectively.Results The urgent explorative laparotomy provided a definitive diagnosis in 31(59.62%) cases.There were 39(75%) patients were treated with primary repair or resection and anastomosis,and 13(25%) with diverting colostomy,2 cases colon leakage,5 cases died.Mortality was most often caused by associated organ injuries,hemorrhagic shock,severe secondary infection or MODS.Conclusions Explorative laparotomy is most useful diagnostic methods.Surgical procedures should be selected according to the degree of colorectal injuries,intra-abdominal contamination and patient's condition.Primary repair or resection and anastomosis are safe therapy for most colorectal injuries.

关 键 词：结肠损伤 直肠损伤 诊断 治疗 外科手术 

分 类 号：R656.9[医药卫生—外科学]