原发性腹茧症的诊断与治疗  

The diagnosis and treatment of primary abdominal cocoon

作　　者：阮小蛟[1] 周锋[1] 王琛 黄瀚章 韩少良[1] Ruan Xiaojiao;Zhou Feng;Wang Chen;Huang Hanzhang;Han Shaoliang(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院胃肠外科,浙江省325000

出　　处：《中华普通外科杂志》2019年第1期39-41,共3页Chinese Journal of General Surgery

摘　　要：目的探讨原发性腹茧症的临床特点及诊疗方法。方法回顾性分析1995年1月至2017年12月间温州医科大学附属第一医院诊治的16例原发性腹茧症患者的临床资料、手术所见及手术结果。结果本组16例原发性腹茧症患者中仅2例术前CT扫描诊断为腹茧症,其余14例均经手术确诊。术中均见部分或全部小肠被一层乳白色致密质韧的纤维薄膜所包裹、呈成团粘连,纤维膜两侧附着于肠系膜根部,肠管与包膜、肠管与肠管之间广泛粘连,肠管之间粘连相对较疏松,较易剥离,可完整锐性剥脱。14例患者均行腹腔粘连松解术+纤维包膜切除术,其中2例患者同时行小肠部分切除,2例因阑尾充血水肿而行单纯阑尾切除术。术后发生切口感染1例,无吻合口瘘等并发症。随访3个月~7年,中位随访时间3.6年,未发现复发病例。结论手术是治疗临床症状明显的原发性腹茧症的主要方法,多数患者预后较好。Objective To investigate the clinical characteristics,diagnosis and treatment of primary abdominal cocoon. Methods The clinical data of 16 cases of primary abdominal cocoon were reviewed and analyzed. Results Only in 2 cases in which correct preoperative diagnosis was estabished by CT scan.The other 14 cases were diagnosed during operation.Parts or all small intestines were covered with a layer of milky white dense fibrous thin membrane,formed mass-likely adhesion,and fibrous film attached to the mesenteric roots.Extensive adhesion existed in between intestines.The operation included lysis of peritoneal adhesion plus fibrous membrane excision in 14 cases,lysis of peritoneal adhesion plus fibrous membrane excision and segmental enterectomy in 2 cases,and in 2 cases appendectomy was done.There was no anastomotic leakage or other major complications except for wound infection in 1 case.All the patients were followed up from 3 months to 7 years with a median follow-up time of 3.6 years,and no recurrent cases were found. Conclusions Surgery is the main method for the treatment of abdominal cocoon with evident clinical symptoms,and the prognosis is largely fair.

关 键 词：腹膜纤维化 肠梗阻 外科手术 

分 类 号：R656[医药卫生—外科学]