乙状结肠自发性穿孔的诊治探讨

Study on the diagnosis and management of spontaneous perforation of the sigmoid colon

目的分析乙状结肠自发性穿孔的病因、临床表现及处理原则。方法回顾性分析32例乙状结肠自发性穿孔患者的临床资料。结果本病以老年患者多见,常伴有便秘、糖尿病、高血压等疾病。本组均根据手术及病理报告而明确诊断,术前误诊率达96.9%。本组死亡15例,死亡率为46.9%。结论乙状结肠自发性穿孔的误诊率高,及时而合理的手术治疗是降低乙状结肠自发性穿孔死亡率的关键。

Objective To evaluate the etiopathogenisis, clinical manifestation and treatment of spontaneous perforation of the sigmoid colon. Methods Clinical data of 32 patients with spontaneous perforation of the sigmoid colon was analyzed retrospectively. The majority of 32 cases were aged patients with chronic constipation, diabetes or hy- pertension. Results The final diagnoses of all the cases were derived from operation and pathological report. The preoperative misdiagnosis rate was 96.9%. 15 patients died after operations and the mortality rate was 46. 9%. Conclusion The preoperative misdiagnosis rate of spontaneous perforation of the sigmoid colon is high. Prompt and pertinent operative therapy contributes to the low mortality rate in spontaneous perforation of the sigmoid colon.