闭合性肠系膜损伤的诊治

Treatment of closed mesenteric injury

目的探讨闭合性肠系膜损伤的诊治。方法对1992年10月￣2004年10月收治的31例闭合性肠系膜损伤的临床资料进行回顾性分析。结果术前误诊为其他疾病23例(74.2%)。血肿清除术6例,肠切除术5例,肠系膜上静脉修补术4例,肠系膜上静脉结扎术2例,肠系膜修补术13例,结肠造口术1例。术后腹腔脓肿1例,切口感染2例,切口裂开1例。死亡1例。结论闭合性肠系膜损伤缺乏特征性临床表现,容易漏诊误诊。早期诊断及手术治疗能有效降低病死率,预防并发症发生。

[Objective] To study the treatment of closed mesentcric injury. [Methods] The clinical date of 31 cases of dosed mesenteric injuries form October 1992 to October 2004 were analyzed retrospectively. [Results] 23 cases （74.2%） had been misdiagnosed preoperatively. Clearance of sludged blood were performed in 6 cases, resection of intestine in 5 cases, repair of sunerior mesenteric vein in 4 cases, ligation of superior mesenteric vein in 2 cases, repair of rnesenteric defect in 13 cases and colostomy in 1 case. In the 31 cases, 1 case died, wound was infected in 2 cases, wour, d crocked in 1 case. [Conclusions] The dosed mesentetic injury lacks typical clinical presentation, a.nd misdlagnosis is not uncommon, The correct diagnosis and emergent operation can lower the mortality of the trauma and certai, complications.