肠道综合处理在左半结肠急症一期吻合术中的应用

Application of the Comprehensive Processing of Bowel for Primary Anastomosis after Left Hemicolectomy in Emergency

目的探索安全、有效、能减轻患者痛苦的左半结肠急症一期切除吻合术。方法对28例因左半结肠肿瘤、扭转、外伤所致的左半结肠急症并需急诊手术的患者,进行一期切除吻合术,附加盲肠置管造瘘、结肠腔内置管肛门引出术,术中采用常规肠减压、结肠加压灌洗以及吻合口处放置腹腔引流等肠道综合处理措施。结果左半结肠急症一期切除吻合术28例,出现吻合口瘘1例,经保守治疗7d治愈,全组无一例死亡。结论经肠道综合处理左半结肠急症一期切除吻合术,是左半结肠急诊外科治疗一种较好的选择。

Objective To explore effective and safe method of primary anastomosis after left hemicolectomy in emergency,Methods Primary anastomosis after left hemicolectomy was done with a tube into cecum for drain,anal draining,and technique of on-table lsvage and celiac draining in 28 cases with acute left hemicolonic surgical disesses,Results None of the 28 patients died and one case with anastomosis fistuls was cured after treatment for one week.Conclusion It indicated that comprchensive processing of bowel in primary anastomosis of left hermioolectorny in emergency has good clinical result with preoperative preparations and technic principle,and it is a good choice for acute left hemicolonic diseases.