腹茧症9例诊治分析并文献复习  

Diagnosis and treatment of abdominal cocoon:Clinical analysis of nine cases with a literature review

作　　者：程相阵 Xiangzhen Cheng(Department of Surgery,Shijingshan Teaching Hospital of Capital Medical University,Beijing Shijingshan Hospital,Beijing 100043,China)

机构地区：[1]首都医科大学石景山教学医院、北京市石景山医院普外科,北京100043

出　　处：《中华临床医师杂志（电子版）》2023年第9期968-971,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的通过9例腹茧症患者患病情况的分析,同时对既往报道的970例腹茧症患者的诊治情况进行文献复习,探讨原发性腹茧症的临床特点及诊疗方法,以提高外科医师对该病诊治水平。方法回顾性分析2008年~2021年北京市石景山医院收治的9例腹茧症患者的临床资料及诊疗情况,同时对腹茧症患者的诊治情况进行文献复习。结果本研究纳入腹茧症患者979例,857例腹茧症患者(87.5%)有肠梗阻症状,261例(26.7%)患者表现为腹部包块。笔者医院收治的9例腹茧症患者中,3例(33.3%)可见小肠系膜聚集、牵拉,系膜内血管走行异常。721例(73.6%)腹茧症患者行纤维包膜切除、肠粘连松解术,246例(25.1%)行阑尾切除。术后134例(23.1%)再次发生肠梗阻。结论对于无症状或者症状轻微的腹茧症患者应以保守治疗为主,以急性肠梗阻表现的腹茧症患者,应积极进行手术治疗。加强围手术期的综合治疗有助于减少并发症的发生。Objective To analyze clinical characteristics,diagnosis,and treatment of nine abdominal cocoon patients and to perform a review of the revelant literature to improve surgeons'diagnostic level and understanding of this disease.Methods Clinical data and surgical results of nine patients with abdominal cocoon diagnosed and treated at Beijing Shijingshan Hospital from 2008 to 2021 were retrospectively analyzed.A literature review was also performed on the diagnosis and treatment of abdominal cocoon patients.Results This study included a total of 979 patients with abdominal cocoon,of whom 857(87.5%)had symptoms of intestinal obstruction,and 261(26.7%)had an abdominal mass.Among the nine cases of abdominal cocoon admitted to our hospital,three(33.3%)showed mesenteric aggregation and traction,and abnormal course of mesenteric blood vessels.Of all the 979 patients included,721(73.6%)underwent fibrous capsule excision and intestinal adhesion release,and 246(25.1%)underwent appendectomy.Postoperative ileus recurred in 134(23.1%)cases.Conclusion Patients with abdominal cocoon without symptoms or mild symptoms should be treated conservatively,while patients with abdominal cocoon with acute intestinal obstruction should be treated actively by surgery.Strengthening comprehensive treatment in the perioperative period is helpful to reduce the occurrence of complications.

关 键 词：腹茧症 肠梗阻 外科手术 

分 类 号：R656[医药卫生—外科学]