8例血清HIV阳性肠梗阻外科治疗体会

Experiences of Surgical Treatment in 8 Intestinal Obstruction of HIV Seropositive Cases

目的:探讨HIV阳性肠梗阻病例的原因、术后切口愈合情况和外科治疗经验。方法:回顾分析了卢旺达基本戈医院8例血清HIV阳性肠梗阻病例的临床资料。结果:8例HIV阳性肠梗阻中6例为腹腔脓肿引起,2例为肠套叠引起;术后2例发生切口感染,感染率25%;1例发生切口裂开;余切口均愈合,但延期拆线,愈合率62.5%;8例患者在术中均行不加缝合的小肠顺序折叠排列术(以下简称肠排列术),术中对腹腔进行反复冲洗,并放置引流;关腹时对切口进行反复冲洗,并进行不留空隙的缝合。结论:HIV阳性肠梗阻患者可进行手术治疗,术中行肠排列,术后应强化抗炎,积极补充营养和调节水电平衡,防止并发症,提高手术治愈率。

Objective：To explore causes and incision conditions as well as surgical treative experience in the intestinal obstruction of HIV seropositive cases.Methods： To analyse 8 cases clinical materials in HIV seropositive intestinal obstruction retrospectly.Results： There are 6 cases abdominal cavity abscess and 2 intussusception cases in the 8 intestinal obstruction cases.Two cases occur incision infection in the postoperation,the rate of infection is 25%,especially,one cases occurs incision dehiscence on twelveth days in the postoperation.The incisions of another patient are cure,the rate of cure is 62.5%.To wash the abdomianl cavity again and again after ablating abscess and loosening intussusception.Also to arrange the intestine and put the drainage tube in the 8 cases of HIV seropositive intestinal obstruction,then suture every layer not to leave space in the incision.Conclusion： the intestinal obstruction of HIV seropositive cases can do the operation,but should intensify to resist inflammation treatment and supply plasma as well as prevent incision infection and dehisence.Also to prevent the intestinal obstruction recurrence and improve the rate of operative cure positively.