右半结肠切除治疗阑尾炎术后肠瘘疗效分析  

Curative effect analysis of right hemicolectomy for intestinal fistula after appendectomy

作　　者：任莹坤[1] 韩广森[1] 赵玉洲[1] 李剑[1] 顾焱晖[1] 鲁朝敏[1] 王有财[1] 杨永威[1] 

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院)普外科

出　　处：《临床外科杂志》2015年第4期278-279,共2页Journal of Clinical Surgery

摘　　要：目的：探讨右半结肠切除治疗阑尾炎术后肠瘘的手术技巧及疗效。方法回顾性分析2007年4月~2012年10月25例在我科接受右半结肠切除术的阑尾切除术后肠瘘患者临床资料，分析手术技巧和近期疗效。结果全组患者平均手术时间（55.6±15.0）min，平均出血量（165.0±24.0）ml；术中炎症水肿肠道平均长度（15.0±6.5）cm，平均切除肠道长度（23.0±4.6） cm；术中发现右下腹部炎性肿块20例，局部分隔性积脓5例，二次手术腹腔脓液培养细菌阳性24例；全组无吻合口瘘病例，术后无腹腔积液、感染患者。平均住院时间（12.0±3.6）d。结论右半结肠切除可用于治疗阑尾炎术后肠瘘，但需把握好手术时机，严格掌握手术适应证及手术技巧。Objective To investigate the surgical techniques and short-term effects of right hemi-colectomy in the treatment of intestinal fistula after appendectomy. Methods From April 2007 to October 2012,a total of 25 patients with intestinal fistula after appendectomy received right hemicolectomy in our department,and the data were analyzed retrospectively. Results The mean operation time was（55. 6 ± 15）min,and the average blood loss was（165 ± 24）ml;the average length of intestinal inflammation and edema was（15 ± 6. 5）cm,and the average length of resected intestine was（23 ± 4. 6）cm;inflammatory mass of the right lower abdomen was intraoperatively found in 20 cases,compartmentalized empyema was locally found in 5 cases,and pus culture was positive in 24 cases;there were no cases of anastomotic leak-age,ascites or infection after operation. The average length of hospital stay was（12 ± 3. 6）d. Conclusion Right hemicolectomy is available for treating intestinal fistula after appendectomy,but the operation tim-ing,surgical indications and techniques should be strictly controlled.

关 键 词：阑尾炎 肠瘘 右半结肠切除 

分 类 号：R656.9[医药卫生—外科学]