急性肠梗阻的手术治疗

目的探讨急性肠梗阻手术时机的选择。方法收集2009年3月～2010年9月间行手术治疗的急性肠梗阻患者53例,进行分析、总结。结果 53例病人中,粘连性肠梗阻20例,肠道肿瘤11例,嵌顿疝10例,肠扭转8例,先天性发育异常2例,肠腔内异物1例,肠套叠1例。术中行小肠切除吻合18例;结肠切除吻合及各类结肠造瘘13例;嵌顿疝复位修补8例;肠扭转复位6例;粘连松解6例;小肠切开取异物1例;单纯剖腹探查1例。术后因各种原因自动出院4例,余患者治疗效果满意,无围手术期死亡病例。结论腹腔粘连是急性肠梗阻的主要病因;急性肠梗阻的病情演变却是一个动态的过程,应密切观察病情变化,正确评估及判断,及时的手术是治疗的关键。

Objective To discuss the operation timing of acute bowel obstruction.Methods These 53 patients who had the disease of bowel obstruction were treated by surgery from Mar 2009 to Sep 2010 are collected,analyzed and summarized.Results In 53 patients,adhesive bowel obstruction is 20 cases,tumor is 11 cases,hernia is 10 cases,volvulus is 8 cases,congenital anomalies is 2 cases,1 case has foreign body in the intestine and 1 case has intussusception.18 of them have small bowel resected and coincided;13 patients have colon resected and coincided or have many kinds of colostomy,8 patients have hernia repaired;6 patients have volvulus were reseted;6 patients have adhesiolysis;1 patient has foreign body in the small intestine is removed and 1 patient only has the surgery of laparotomy.After operation,4 cases leave the hospital early,because of many kinds of reasons,other patients have satisfied recovery,no perioperative deaths.Conclusion Adhesions is a major cause of acute intestinal obstruction;The state of acute intestinal obstruction is a dynamic process,should closely observed,assessed and judged;Timely surgery is the key for the diease.