手术治疗绞窄性肠梗阻81例临床体会

Clinical experience in 81 strangulating intestinal obstruction treated by operation

目的探讨绞窄性肠梗阻的早期诊断及有效的手术治疗方法。方法回顾性分析经手术治疗81例绞窄性肠梗阻的临床资料。结果术前确诊为绞窄性肠梗阻者有59例(72.8%),且大多数为肠坏死;其余22例(27.2%)则分别以单纯性肠梗阻或其他急腹症行剖腹探查而确诊。本组均行手术治疗,治愈76例;死亡5例,死亡率为6.17%。其主要死亡原因是感染中毒性休克、多脏器功能衰竭及严重水电解质紊乱及酸碱失衡。结论绞窄性肠梗阻早期诊断较困难,应根据临床特点和辅助检查,严密观察其动态变化,综合分析判断,把握手术时机,预防肠坏死的发生,早期诊断及时进行手术治疗是提高救治成功的关键。

Objective To investigate the early diagnosis and operative manner of strangulating intestinal obstruction. Methods Retrospective analysis on the clinical material of 81 patients with strangulating intestinal obstruction. Results There were only 59 patients （72.8%） diagnosed as strangulating intestinal obstruction before operation. The other 22 patients were diagnosed after operation. All patients were treated by operation. 76 patients were cured, 5 patients died（mortality was 6.17% ）. The main cause of death was septic poisonous shock ,MOF and severe disturbance of water-electrolyte, acid-base imbalance. Conclusion The early diagnosis of strangulating intestinal obstruction is difficult. Intestine necrosis should be prevented by analyzing carefully the clinical feature and related examinations. The early diagnosis and operation are the key points to cure the patients.