结直肠癌穿孔的外科治疗(附40例报告)  

The intestinal perforation's clinical symptoms and diagnosis

作　　者：王钧[1] 郑九星[1] 徐小萍[1] 王丰玲[2] 张光辉[2] 陈道达[3] 

机构地区：[1]湖北省宜昌市三峡大学医院普外科,443002 [2]湖北省宜昌市三峡大学医院第三临床医院,443002 [3]武汉市华中科技大学同济医学院附属同济医院胃肠外科,湖北武汉430030

出　　处：《淮海医药》2009年第1期24-25,共2页Journal of Huaihai Medicine

摘　　要：目的探讨结肠癌和直肠癌并发肠穿孔的外科治疗方法及分析。方法分析40例结肠癌和直肠癌并发肠穿孔的外科治疗资料。结果本组40例中,16例行1期切除吻合术,其中4例发生吻合口漏。16例行1期病灶切除吻合术,近端肠段外置双管造瘘术。6例切除肿瘤所在肠段,近端行端式结肠造口术,远端封闭(Haitman)术。4例行单纯造瘘术。手术后并发症的发生率为50%(20/40),围手术期的死亡率为20%(8/40)。结论重视对结肠癌和直肠癌并发肠穿孔的认识,选择合适的手术方式,做好围手术期的治疗是减少并发症、提高治疗效果的重要措施。Objective To explore the surgical treatment cases of colon and rectum cancer combined with intestinal perforation. Methods Data were analyzed concerning the surgical treatment of 40 cases of colon and rectum cancer combined with intestinal perforation. Results Sixteen of the 40 cases underwent phase 1 resection and anastomosis, among whom 4 cases of anastomotic leakage occueeed. Sixteen cases received phase 1 local resection and anatomosis as well as fistulization at the proximal end of the bowel. The tumor segment of the bowel of 6 cases was excised coupled with colon-ostomy at the proximal end and Hartmann at the distalend. Four cases were dealt with simple fistulization. The incidence of postoperative comlicatians was 50% （20/40） and the perioperative mortality 20% （8/40）. Conclusion Great importance should be attached to colon and rectum cancer combined with intestinal perforation. Proper operational pattern ,careful pefioperative treatment and reduction of complications contribute to the satifactory outcome.

关 键 词：结直肠肿瘤 肠穿孔 外科手术 治疗结果 

分 类 号：R735.3[医药卫生—肿瘤]