绞窄性肠梗阻154例临床诊治分析  

Clinical diagnosis and treatment of 154 cases of strangulated intestinal obstruction

作　　者：朱艳志[1] 马海霞[1] 兰浩铭[1] 周猛[1] 张敏[1] 周平[1] 菅志远[1] 兰明银[1] 

机构地区：[1]湖北医药学院附属太和医院普外1科,湖北十堰442000

出　　处：《腹部外科》2015年第5期360-362,共3页Journal of Abdominal Surgery

摘　　要：目的 探讨绞窄性肠梗阻的临床诊治方法.方法 回顾性分析2006年1月至2015年1月期间收治的154例绞窄性肠梗阻病人的临床资料,分析其病因、临床表现及辅助检查结果.154例绞窄性肠梗阻病人均行手术治疗,行肠粘连松解51例,肠扭转复位30例,小肠部分及大部分切除28例,疝内容物还纳联合疝高位结扎修补术13例,肠套叠复位11例,乙状结肠切除术10例,回盲部切除术6例,左半结肠切除术5例.结果 本组病人行手术治疗,治愈146例,治愈率为94.8％;死亡8例,死亡率为5.2％.死亡原因：感染性休克4例,多器官功能衰竭2例,腹腔严重感染死亡1例,短肠综合征并严重水、电解质紊乱1例.结论 绞窄性肠梗阻病人起病较急,早期诊断并及时手术治疗是降低死亡率的关键.Objective To investigate the clinical diagnosis and treatment of strangulated intestinal obstruction. Methods The clinical manifestation, etiology, supplementary examination results and instruments of 154 cases of strangulated intestinal obstruction from Jan. 2006 to Jan. 2015 were retrospectively analyzed. Operation was performed on all the 154 patients, including 51 cases of accretionlysis, 30 of volvulus reduotion, 28 of partial intestinal resection and massive resection, 13 of hernia sac high ligation and repair, 11 of intussusception reduction, 10 of sigmoidectomy, 6 of ileocecal junction resection and 5 of left hemicolectomy. Results All the cases were definitely diagnosed as strangulated intestinal obstruction. 146 cases were cured, and the curative rate was 94. 8%. Eight cases died, and the mortality rate was 5.2%. Four cases died of septic shock,2 of multiple organ failure, 1 of severe intraperitoneal infection and 1 of short bowel syndrome and serious fluid and electrolyte disturbances. Conclusions The characteristics of strangulated intestinal obstruction are short course. Early diagnosis and timely operation treatment are critical for the reduction of mortality rate.

关 键 词：肠梗阻 绞窄性 急诊手术 

分 类 号：R574.2[医药卫生—消化系统]