闭合性腹部损伤致结肠破裂30例诊断与治疗

Diagnosis and treatment of 30 patients with colon rupture induced by blunt abdominal injury

目的探讨对于闭合性腹部损伤导致结肠破裂患者的临床诊断及治疗方法。方法回顾性分析本院于2007年1月～2012年12月所收治的30例闭合性腹部损伤导致结肠破裂患者的临床资料，总结其诊断及治疗方法。结果所有患者均行手术治疗，其中治愈27例，治愈率为90％，死亡3例，死亡率为10％；有5例术后出现刀口感染，2例出现腹腔内脓肿，1例出现粘连性肠梗阻症状，经换药及2次手术治疗后治愈。结论对于闭合性腹部损伤所导致的结肠破裂．早期明确诊断能够降低患者的死亡率及相关并发症的发生，结肠破裂后围术期感染是其主要的并发症．应注意预防。

Objective To investigate the clinical diagnosis and treatment of patients with colon rupture induced by blunt abdominal injury. Methods The clinical dates of 30 patients with colon rupture induced by blunt abdominal in- jury admitted to our hospital from January 2007 to December 2012 were retrospectively analyzed and summarized for diagnosis and treatment. Results All patients were treated by surgical operation. Twenty seven eases were cured with curative rate of 90%; 3 cases died with mortality of 10%; 5 cases underwent incision infection after operation; 2 cases got intra-abdominal abscess; 1 case cured by dressing change and twice of surgical operation for symptoms of adhesive ileus. Conclusion For colon rupture induced by blunt abdominal injury, early confirmed diagnose can decrease mor- tality and related complications. The main perioperative infection is the main complication after colon rupture and should be prevented with special attention.