腹部外科近期再手术65例分析

Analysis of 65 Cases of Recent Abdominal Reoperation

目的探讨腹部外科近期再手术的原因、预防及处理方法。方法对我院1989年1月～2009年1月收治的腹部外科近期再手术65例的临床资料进行回顾性分析。结果本组再手术的原因为肠梗阻20例，腹腔感染14例，腹腔内出血10例，引流管并发症8例，其他原因7例，遗留病变6例。2次手术距1次手术时间最短3h，最长1个月，65例共手术114例次，最多者4次。本组57例治愈；死亡8例，其中死于肝。肾衰竭、心肌梗死各1例，因恶性肿瘤再次手术后全身衰竭死亡6例。结论腹部外科近期再手术原因复杂，早期诊断并选择再手术的时机及有效的术后综合治疗是提高再手术效果的关键。

Objective To investigate the cause, prevention and treatment of recent abdominal reoperation. Methods The clinical datas of 65 patients who underwent recent abdominal reoperations in our hospital during January 1989 and January 2009 were analyzed retrospectively. Results The reoperations were due to intestinal obstruction in 20 cases, abdominal infection in 14 cases, intra-abdominal hemorrhage in 10 cases, remaining lesion in 6 cases, drainage tubes complications in 8 cases, and other causes in 7 cases. The time between the two operations was from 3 h up to 1 month. 65 patients underwent a total of 114 operations, and some patients had as many as 4 operations. 57 patients were cured, and 8 patients died, among whom 1 patient died of liver and kidney failure and 1 of myocardial infarction, and the other 6 died of malignant systemic failure after the second operation. Conclusion The causes of recent abdominal reoperation are complicated. Early diagnosis, choosing the right time of reoperation and taking comprehensive and effective treatment after surgery are the key factors to improve the effects of reoperation.