慢性放射性肠炎并发肠梗阻的治疗

Management of chronic radiation enteritis with intestinal obstruction

目的:探讨慢性放射性肠炎并发肠梗阻的治疗方法及疗效.方法:回顾分析21例慢性放射性肠炎并发肠梗阻的临床资料,对其进行总结.结果:7例保守治疗的病例中有5例复发,治愈率仅(28.6%,2/7),保守治疗效果不佳.14例手术患者总体疗效满意.10例行肠切除吻合术的患者,治愈率达(90.0%,9/10),可见手术治疗为慢性放射性肠炎并发肠梗阻的最佳方法.1例出现吻合口瘘的患者,再次手术证实为第1次手术切除肠管过少,残留病变肠管所致.结论:慢性放射性肠炎并发肠梗阻的最佳治疗方法为手术治疗,手术方式应尽量行肠切除一期吻合术,手术时应尽量切除全部病变肠管,避免出现吻合口瘘.同时肠造口术或旁路手术也是必要术式,应根据具体情况选择.

AIM：To evaluate the effect of various treatmentmethods for chronic radiation enteritis with concurrent intestinal obstruction.METHODS：The clinical data for 21 patientswith chronic radiation enteritis and intestinalobstruction was retrospectively analyzed.RESULTS：Five of seven patients who receivedconservative treatment experienced relapse,andthe cure rate was only 28.6%.Fourteen patientswho underwent surgical treatment（of themten patients underwent intestinal resection andanastomosis） had satisfactory outcome,and thecure rate was as high as 90.0%.One patient developed intestinal f istula,and re-operation confirmed that it was caused by residual radiationenteritis.CONCLUSION：Surgical treatment is the bestway for treatment of chronic radiation enteritiswith intestinal obstruction.All intestinal lesionsshould be surgically removed to avoid intestinalf istula.