摘要
目的总结自发性结肠破裂的病因和发病机制、好发部位、诊疗策略及预防措施。方法回顾性分析32例自发性结肠破裂患者的临床资料,有慢性便秘史21例,冠心病、动脉粥样硬化病史12例,有肠内压增高诱因16例,术前均摄腹部平片,示膈下游离气体19例;行泛影葡胺灌肠造影12例,10例示左半结肠穿孔;腹穿阳性者14例。术前仅3例确诊。行一期修补6例,穿孔段结肠外置造瘘8例,穿孔修补加近段结肠造瘘8例,病变段结肠切除加近段结肠造瘘10例。结果手术证实穿孔部位:乙状结肠10例,直肠乙状结肠交界处11例,降结肠6例,横结肠4例,盲肠1例。治愈19例(59.4%),死亡13例(40.6%)。结论自发性结肠破裂缺乏特异的临床表现,术前不易确诊;本病好发于乙状结肠及直肠乙状结肠交界处;对本病有充分认识及术前泛影葡胺灌肠造影有利于术前诊断;依患者全身及腹部情况选择一期或二期手术。
Objective To summarize the etiopathogenisis,pathogenesy,predilection sites,diagnostic and therapeutic strategies and preventive measures for spontaneous perforations of colon.Methods Clinical data of 32 cases of colonic spontaneous perforation was retrospectively analyzed.Plain abdominal radiography was performed in all the 32 cases with 19 showed subdiaphragmatic free air.Cardiografin coloclysis and photography was performed in 12 cases and 10 showed left colonic perforation.And abdominal paracentesis show...
出处
《中国现代手术学杂志》
2009年第1期13-15,共3页
Chinese Journal of Modern Operative Surgery
关键词
结肠疾病
破裂
穿孔
colonic diseases
rupture
perforation
