顺行封闭式结肠灌洗在左半结肠急性梗阻Ⅰ期切除吻合中的应用  

Application of one-stage resection and anastomosis by anterograde closed-end coloclysis for acute left-semicolon obstruction

作　　者：莫乃榕[1] 哈晓冬 陈华锋[1] 谈瑞芳[1] 吴登东 

机构地区：[1]广东省肇庆市第二人民医院普外科,肇庆526060

出　　处：《临床医学》2013年第3期3-5,共3页Clinical Medicine

基　　金：广东省肇庆市科技创新项目(2011E321)

摘　　要：目的探讨Ⅰ期切除吻合治疗左半结肠急性梗阻的方法及围术期处理原则。方法回顾性分析肇庆市第二人民医院2009年1月至2012年10月Ⅰ期切除吻合治疗左半结肠急性梗阻32例患者的临床资料。结果术后32例均痊愈出院,无吻合口瘘,6例并发切口感染,3例并发肺部感染,1例并发胃排空障碍。结论对全身情况较好、无严重并存病、能耐受较长手术时间、梗阻时间短及术中肠道灌洗满意的左半结肠急性梗阻患者,术中行充分肠减压和顺行封闭式结肠灌洗,I期切除吻合是安全可靠的,围术期营养支持、高效广谱抗生素应用、手术技术提高等是预防吻合口瘘的关键。Objective To investigate the procedure＇s choice and perioperative management of the acute left-semicolon obstruction by one-stage resection and anastomosis.Methods The clinical data of 32 patients with acute left-semicolon obstruction operated upon one-stage resection and primary anastomosis between January 2009 and October 2012 were retrospectively reviewed.Results All of the 32 cases were cured.There were no anastomotic leakage.Six cases of the 32 cases occurred incision infection,3 cases occurred pulmonaryinfection,1 case occurred dyfunction of the stomach peristalsis.Conclusion One-stage resection and primary anastomosis of acute left-semicolon obstruction is on the safe side,but the indication must be commanded strictly.Nutrition support treatment perioperative,using highly effective,wide-spectrum antibiotics,improving the surgical technique are the key to prevent the anastomotic leakage.

关 键 词：急性肠梗阻 乙状结肠扭转 左半结肠癌 顺行封闭式结肠灌洗 Ⅰ期切除吻合 

分 类 号：R735.35[医药卫生—肿瘤]