异物性肠穿孔10例临床分析  

Intestinal Perforation due to Foreign Body:10 Cases Report

作　　者：徐海宾 李卫平[1] XU Hai-bin;LI Wei-Ping(Department of General Surgery,Taicang Affiliated Hospital of Soochow University(The First People’s Hospital of Taicang),Taicang 215400,Jiangsu,China)

机构地区：[1]苏州大学附属太仓医院(太仓市第一人民医院)普外科,江苏太仓215400

出　　处：《中国现代手术学杂志》2022年第4期261-265,共5页Chinese Journal of Modern Operative Surgery

基　　金：江苏省太仓市科技计划项目(编号:TC2021JCYL18)。

摘　　要：目的总结消化道异物致成人肠穿孔的临床特征及诊治经验。方法回顾性分析2011年8月至2020年10月我科收治的10例异物导致肠穿孔患者的临床资料。结果本组异物性肠穿孔患者中十二指肠穿孔1例,空肠穿孔3例,回肠穿孔4例,乙状结肠穿孔2例。所有患者均行急诊手术治疗,其中8例行剖腹探查术,2例行腹腔镜探查术(其中1例中转开腹),均顺利完成手术并治愈,住院时间2~18 d。术后出现切口感染3例,肺部感染1例,经积极对症治疗后恢复良好出院。术后随访6个月患者均无特殊不适。结论异物性肠穿孔临床较为少见,对病史及影像学检查可疑者应警惕异物性肠穿孔可能;治疗可根据病情选择剖腹探查或腹腔镜探查术,术中若发现可疑肠管,应进一步探查以免漏诊,其预后一般良好。Objective To summarize the clinical features,diagnosis and treatment experience of adult intestinal perforation caused by various gastrointestinal foreign bodies.Method The clinical data of 10 patients with intestinal tract perforation due to foreign body underwent surgical intervention from August 2011 to October 2020 were analyzed retrospectively.Results There was duodenal perforation in one case,jejunum perforation in 3 cases,ileal perforation in 4 cases and sigmoid colon perforation in 2 cases.All patients underwent emergency exploration,including eight cases of laparotomy and two cases of laparoscopic exploration(one case converted to open surgery).All patients completed the operation successfully with 2 to 18 days of post-operative hospital stays.Postoperative wound infection occurred in 3 cases and pulmonary infection in 1 case,and the 4 patients recovered well and were discharged from hospital after symptomatic treatment.All patients were followed up for six months without special discomfort.Conclusions Intestinal perforation associated with foreign body is rare in clinic.The patients with suspicious medical history and imaging features by examination should be alert to the possibility of intestinal perforation of foreign body.Open exploration or laparoscopic exploration can be chosen according to the condition of the patients.Further exploration should be performed to avoid missed diagnosis when suspicious bowel injury is found during the operation,and good prognosis can be achieved.

关 键 词：肠穿孔 消化道异物 

分 类 号：R656.7[医药卫生—外科学]