肝切除术后肠壁囊样积气症

Pneumatosis intestinalis after hepatectomy

目的探讨肝切除术后严重腹胀病人合并肠壁囊样积气的发生原因及防治。方法统计分析2004年1月至2007年1月东方肝胆外科医院32例肝切除术后严重腹胀并行腹部平片和（或）CT检查病人的病历资料。结果32例病人中有5例发现肠壁囊样积气，占严重腹胀病人的15．6％。4例治愈，1例死于肠系膜血栓形成．肠坏死。平均肝门阻断时间为（28．35±6．46）min，术中平均出血量为（2160．38±356．34）ml。结论肝门阻断时间较长和术中发生大出血的病人可能因肠淤血和缺血而发生严重腹胀和肠肇囊样积气，应引起临床足够的重视。

Objective To investigate the origin, prevention and management of pneumatosis intestinalis after hepatectomy that complicated with serious abdominal distension. Methods The clinical data of 32 patients with serious abdominal distension after hepateetomy who received abdominal radiography and （or） CT scan in our hospital from January 2004 to January 2007 were collected and retrospectively analyzed. Results There were 5 of the 32 patients were diagnosed to suffer from pneumatosis intestinalis. The average hepatic hilum interception time of the 32 patients was （28.35±6.46）min and the average blood loss was（2160.38±356.34）ml. Conclusion The patients having longer hilum in terception time and hemorrhage during hepatectomy may develop congestion and ischemia of intestine to result in serious abdominal distention and pneumatosis intestinalis. More attention should be paid to these patients.