急性肠扭转早期诊治体会  

Early diagnosis and treatment of acute volvulus experience

作　　者：焦桂良[1] 蒋志龙[1] 陆金亮[1] 常来[1] 邱晶晶[1] 丁银新[2] 

机构地区：[1]江苏省泰兴市人民医院普外科,江苏泰兴225400 [2]江苏省泰兴市人民医院放射科

出　　处：《临床急诊杂志》2013年第10期494-496,共3页Journal of Clinical Emergency

摘　　要：目的:总结急性肠扭转的早期诊断及治疗的经验。方法:对我院近5年中的62例急性肠扭转患者的临床表现、检查及治疗方法回顾性分析,探讨肠扭转的早期诊断及治疗问题。结果:51例肠扭转患者经螺旋CT检查确诊,8例经行稀钡灌肠确诊,3例经腹腔镜探查确诊;52例行手术治疗(其中35例系腹腔镜下手术),2例经稀钡灌肠时复位,3例肠镜下复位成功,5例保守治疗好转。结论:早期在临床出现"症征分离"性腹痛时,立即行螺旋CT检查,但检查阴性征象不能轻易排除本病,必要时行腹腔镜探查。对于有急性期肠扭转超过180°以上的患者建议及时早期手术(包括腹腔镜下复位),对于乙状结肠扭转患者,如果症状较轻,可考虑肠镜下或稀钡灌肠试复位,如保守治疗失败或出现肠坏死症状时应及早进行手术。Objective：Summarize the acute volvulus of early diagnosis and treatment experience. Method： The clinical data of 62 cases with acute volvulus admitted in our hospital during the last five years were retrospectively analyzed, including clinical manifestations, inspection and treatment methods, the early diagnosis and treatment of volvulus were disscussed. Result.. 51 casesvolvulus patients were diagnosed by MSCT examination,8 cases were di agnosed witla dilute barium enema, 3 cases were diagnosed by laparoscopic exploration diagnosis~ 52 cases under- went routine surgical treatment（35 cases of laparoscopic surgery department）, 2 cases restored flowing dilute bari um enema ,3 cases restored by colonoscopy, 5 cases get better by conservative treatment. Conclusion： Spiral CT should be carried on immediately when ＂diseas sign separation＂ abdominal pain appears early, , but the disease can not be easily ruled out when we got negative signs , laparoscopic exploration is necessary. For pataients wiht acute volvulus exceed 180° , early surgery is recommended （ including laparoscopic reset ）, For patients with sigmoid torsional, if symptoms are mild, colonoscopy or dilute barium enema reset may be considered,if conservative treat ment fails or bowel necrosis symptoms appears, surgery should be taken as soon as possible.

关 键 词：急性肠扭转 早期诊断 治疗 

分 类 号：R656[医药卫生—外科学]