103例绞窄性肠梗阻死亡原因及预后影响因素的探讨

Investigation on the causes of death and influential factors for the prognosis of 103 cases of strangulating intestinal obstruction

目的 探讨绞窄性肠梗阻的死亡原因和预后影响因素.方法 回顾性分析2001年8月至2009年11月收治的103例绞窄性肠梗阻患者的临床资料.结果 所有患者均经手术治疗,术前确诊绞窄性肠梗阻55例（53.4%）,其余48例（46.6%）均在开腹探查时确诊.治愈92例,死亡11例,病死率为10.7%（11/103）.主要死亡原因为感染性休克、多器官功能障碍综合征、急性呼吸窘迫综合征和急性肾衰竭,其中感染性休克是影响预后最重要的独立因素.结论 尽早明确诊断,合理把握手术时机,采取及时有效的手术治疗是降低绞窄性肠梗阻病死率的关键.

Objective To investigate the causes of death and influential factors for the prognosis of patients with strangulating intestinal obstruction. Method The clinical data of 103 cases of strangulating intestinal obstruction admitted from August 2001 to November 2009 were analyzed retrospectively. Results All patients were treated by surgery, 55 cases （53.4%） were diagnosed of strangulating intestinal obstruction before surgery, the remaining 48 cases （46.6%） were diagnosed underwent laparotomy. Ninety two cases were cured, 11 cases died,the mortality rate was 10.7%. Major causes of death were septic shock,multiple organ dysfunction syndrome （MODS）, acute respiratory distress syndrome （ARDS） and acute renal failure,septic shock was the most important independent factor that affect the prognosis. Conclusion Clear and early diagnosis,rational decision of the timing of surgery,and prompt and effective surgical treatment is the key to reduce mortality in strangulated intestinal obstruction.