乙状结肠扭转预后因素分析

Prognosis factors analysis for sigmoid vulvulus

目的总结乙状结肠扭转病人的合理诊治。方法对55例乙状结肠扭转病人进行回顾性分析。结果乙状结肠扭转好发于60岁以上的老年男性,误诊率达36.4%,急诊手术死亡率达25.8%,择期手术的死亡率为8.7%。年龄60岁以上、术前存有内科疾病、术后出现严重并发症、一期乙状结肠切除吻合术及Hartmann's术的死亡率高。结论乙状结肠扭转多见于老年男性,患者年龄、围手术期处理、手术方式、术后是否出现并发症及正确诊断是决定病人预后的关健因素。

[Objective] To summarize reasonable diagnosis and optimal therapy for patients with sigmoid vul-vulus. [Method] A retrospective analysis was carried out in 55 cases of sigmoids vulvulus. [Result] Sigmoid vulvulus was liable to the male piatients over 60 years old, and the common incentive was long-term chronic constipation and press inside abdominal increased suddenly. The mortality rate was 25.8% for emergent surgery and 8.7% for elective procedures. It was high when patients＇ age was over 60 years and there were internal diseases preoperative or severe complications postoperative after suffered from sigmoidectomy-anastomosis or Hartmann＇s operative. [Conclusion] Sigmoid vulvulus is liable to the old male piatients, the key factors for patient＇s prognosis are determined by patients＇ age, perioperative correct therapy, optimal operative method, complication postoperative and correct diagnosis.