11例自发性结肠穿孔诊治分析  

Diagnosis and treatment of spontaneous colonic perforation:analysis of 11 cases

作　　者：郑刚 任德发 欧阳焱黎 邵力伟 Zheng Gang;Ren Defa;Ouyang Yanli;Shao Liwei(Department of General Surgery,The Fifth Hospital of Wuhan,Wuhan 430050,Hubei,China;Department of Pathology,The Fifth Hospital of Wuhan,Wuhan 430050,Hubei,China)

机构地区：[1]武汉市第五医院普通外科,湖北武汉430050 [2]武汉市第五医院病理科,湖北武汉430050

出　　处：《结直肠肛门外科》2020年第3期358-360,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的分析自发性结肠穿孔的病因、诊断和治疗。方法对2000年1月至2019年6月收治的11例自发性结肠穿孔患者的临床资料进行回顾性分析。结果患者平均年龄(68.2±2.8)岁,7例合并便秘,所有患者均进行了急诊手术,其中乙状结肠穿孔6例,直乙交界部位、降结肠和横结肠穿孔各1例,升结肠穿孔2例。行Hartmann术7例,2例行穿孔部位结肠外置造口,2例升结肠穿孔行结肠修补术+回肠造口术。9例患者治愈,2例术后因严重脓毒症死亡。结论自发性结肠穿孔常发生于有便秘史的老年患者,临床表现缺乏特异性,CT对诊断的帮助很大,早期手术是降低术后并发症发生率和死亡率的关键。Objectives To analyze the etiology,diagnosis,and treatment of spontaneous colonic perforation.Methods The clini⁃cal data of 11 cases of spontaneous colonic perforation treated between January 2000 and June 2019 were analyzed retrospective⁃ly.Results The mean(SD)age of the patients was 68.2(2.8)years,and seven patients had constipation.All patients under⁃went emergency surgery,including six sigmoid colon perforations,one rectosigmoid perforation,one descending colon perforation,one transverse colon perforation,and two ascending colon perforation.Seven patients underwent Hartmann surgery,and two under⁃went colostomy of the perforated colon.The two patients with ascending colon perforation underwent repair and ileostomy.Nine patients were cured,and two died due to severe sepsis.Conclusion Spontaneous colonic perforation occurs commonly in older patients with a history of constipation.Symptoms often lack specificity in these patients.Computed tomography is useful for diag⁃nosis.Early surgery is crucial in lowering postoperative complication rates and mortality.

关 键 词：结肠 自发性穿孔 腹膜炎 

分 类 号：R656.9[医药卫生—外科学]