粪石性结肠穿孔临床特点的系统评价  

Stercoral Perforation of Colon: A System Evaluation of Clinical Features

作　　者：毕敬涛[1] 郭晏同[1] 赵景明[1] 伊新[1] 王欣[1] 胡琳[1] 刘亚奇[1] 侯晓蕾[1] 

机构地区：[1]北京积水潭医院(北京大学第四临床医学院)普外科,北京市100096

出　　处：《中国全科医学》2014年第21期2478-2482,共5页Chinese General Practice

摘　　要：目的：对粪石性结肠穿孔（SPC）的临床特点进行系统评价。方法采用电子文献数据库和网络引擎两种方法，检索关于SPC的病例报道，进行系统评价。结果最后共纳入54篇文献，其中中文文献15篇，英文文献39篇，共包括91例病例，其中男44例，女47例；年龄4～106岁，平均63.9岁，＞60岁者占63.7％（58/91）。71例病例有排便情况的描述，其中有慢性便秘史者62例（87.3％）。80例病例有腹痛起始部位的描述，其中全腹部30例（37.5％），下腹部26例（32.5％）。63例病例有是否发热的描述，其中发热31例（49.2％）。62例病例术前行立位腹部平片检查，其中6例术前明确诊断，术前诊断率为9.7％；29例病例术前行腹部CT检查，其中16例术前明确诊断，术前诊断率为55.2％。结论 SPC虽然少见，但在急腹症的诊断和鉴别诊断中应常规考虑，对于合并慢性便秘等的老年病例，出现不明原因腹痛时要警惕SPC的可能；腹部CT可作为首选检查。ObjectiveToevaluatesystematicallytheclinicalfeaturesofstercoralperforationofcolon（SPC）.Meth-ods We searched bibliographic data bases and network engines for reports on SPC cases .Results A total of 54 literatures were enrolled, 15 in Chinese, 39 in English, including 91 cases （44 males, 47 females, aged 4 to 106 years, averagely 63.9 years old, those aged〉60 years accounting for 63.7%）.There was description about defecation in 71 cases, thereinto 62 （87.3%） had chronic constipation history; There was description about the initial site of abdominal pains in 80 cases, 30 （37.5%） had pains in whole abdomen, 26 （32.5%） in lower abdomen.There was description about fever in 63 cases, 31 （49.2%） had fever.Sixty-two patients had preoperative erect abdominal plain , and 6 （9.7%） had definite diagnosis before operation; 29 had abdominal CT before operation , and 16 （55.2%） had definite diagnosis .Conclusion SPC is rare, but it needs conven-tional consideration in diagnosis and differential diagnosis of acute abdomen . For elderly combined with chronic constipation , SPC is possible when unexplained abdominal pains appear .Abdominal CT can be the first choice .

关 键 词：肠穿孔 粪便嵌顿 便秘 急腹症 系统评价 

分 类 号：R656.1[医药卫生—急诊医学] R656.9[医药卫生—外科学]