自发性结肠破裂11例报告及国内文献复习  

Diagnosis and treatment of spontaneous rupture of the colon: a report of 11 cases with review of domestic literature

作　　者：蒋勇敢[1] 

机构地区：[1]东南大学附属南京江北人民医院腹部外科,南京市210048

出　　处：《中国临床研究》2013年第6期536-537,540,共3页Chinese Journal of Clinical Research

摘　　要：目的通过回顾性分析和文献复习,提高对自发性结肠破裂的诊治水平。方法回顾分析11年间收治的11例自发性结肠破裂患者的诊治过程和预后。同时在CHKD中检索出自2000年以来的10篇(96例患者)符合自发性结肠破裂诊断标准的国内文献,从患者性别、年龄、疾病发生条件、破裂部位、误诊率、死亡率及决定预后的因素等方面进行统计分析,找出疾病发生、发展和转归的规律。结果符合入选标准的患者107例,男∶女为1.55∶1;年龄主要集中在66.8～75岁;所有患者均经手术确诊,结肠破裂部位主要集中在左半结肠,乙状结肠最多,其次为直肠乙状结肠交界处,两者共占83.2%;术前误诊率高达70.9%;至少82例选择了结肠造瘘术;病死率19.6%。结论自发性结肠破裂发病率虽低,但有其发病基础与易发因素,早期确诊并及时予以恰当的手术方式能提高自发性结肠破裂患者的预后。Objective To improve the diagnosis and treatment of spontaneous rupture of the colon by retrospective analysis of patient data and literature review. Methods 11 patients of spontaneous colon in our hospital in recent 11 years and a literature review of 10 articles （96 patients are involved in）form CHKD since 2000 were collected, and their clinic features are analyzed to find out the regularity of disease occurrence, development and out- come, such as sex, age, disease conditions, rupture sites, the rate of misdiagnosis, mortality and prognostic factors. Results 107 patients were enrolled, male to female was 1.55 to 1. patients were mainly concentrated in the age of 66.8 to 75 years. All the patients were diagnosed by operation. The sites of colon rupture were located mainly in the left colon, sigmoid colon was the most common seen, followed by the rectosigmoid junction, which together account for 83.2%. The preoperative misdiagnosis rate is very high, up to 70.9%. At least 82 patients accepted colostomy. The mortality is 19.6%. Conclusions The incidence of spontaneous rupture of the colon is low, but the basis of the incidence and prone factors exist. Early diagnosis and timely appropriate surgery can improve the prognosis of patients with spontaneous rupture of the colon.

关 键 词：自发性结肠破裂 结肠造瘘术 合并症 误诊率 

分 类 号：R656.7[医药卫生—外科学]