急性肠梗阻的手术时机探讨——附385例临床治疗分析

Study of the timing of operation for acute ileus——385 cases clinical treatment analysis

目的探讨急性肠梗阻手术治疗的最佳时机。方法回顾性分析该院过去13余年间385例急性肠梗阻的诊断治疗过程,选择手术治疗的91例作为研究对象,分析手术治疗的疗效与选择的手术时间的关系。结果385例肠梗阻患者非手术治疗294例,手术治疗91例,共计治愈360例,死亡25例。手术治疗的病例中,治愈82例,死亡9例。入院到手术时间1周内手术76例,死亡5例,超过1周手术的15例,死亡4例(P<0.05)。结论绞窄性肠梗阻不是肠梗阻手术治疗的唯一适应证,急性肠梗阻保守治疗最多不应超过1周,如无效应积极手术,早期及时手术处理是最有效的治疗手段。

[Objective] To study the optimal operation time for acute ileus. [Method] A retrospective analysis of 385 cases of acute ileus in the past thirteen years was used, among which 91 cases, Luho received operation were selected as study subjects. The relationship between operation effectiveness and timing of operation was investigated. [Results] 365 patients had been cured, among which there were 294 nonoperation, and 91 operation cases. Mortality was 5.4% (16/294) and 9.9% (9/91) respectively (P >0.05). Operation management cases was divided into two groups according to the period before operation: longer than 1 week group (n=76) and shorter or equal 1 week group (n=15). The mortality was 6.6%(5/76) and 2.7%(4/15) respectively (P <0.05). [Conclusion] Strangulating intestinal obstruction was not the only indication for operation. The period of nonoperation treatment shouldn′t beyond 1 week. The most effective management method was early operation.