20例创伤性结肠破裂一期手术治疗临床分析

Clinical analysis of surgical treatment for traumatic colon rupture at one-stage repair in 20 cases

目的探讨结肠破裂I期手术治疗的可行性,总结手术治疗的体会。方法本组共20例,均为外伤所致,破裂范围小于1/2肠管周径。创缘常规清创后进行I期修复18例,2例大于2 cm的挫裂伤行Ⅰ期肠管切除吻合。结果实施Ⅰ期手术治疗的20例患者中,术后1例患者出现肠瘘,后经引流、积极治疗等传统治疗后于术后1个半月痊愈,2例患者出现切口感染,伤口换药后于1个月痊愈。结论创伤性结肠破裂患者实施Ⅰ期手术治疗需要严格的适应症选择、术中正确判断及恰当的术后围手术期处理。

Objective To investigate the feasibility of surgical procedure in one-stage closure for traumatic colon rupture and summarize the experience. Method Twenty patients with raumatic colon rupture were included in the study from January 2001 to January 2013. Among 20 cases, 18 cases whose damage ranged on colon less than 1/2 by intestinal circumference were received conventional debridement and one-stage repair for ruptures. The other two patients with large range of injury underwent one-stage closure due to slight peritoneal contamination. Results All patients were recovery from surgical treatment, no death case occurred. One case was confirmed postoperative fistula with localized peritonitis, and cured one month and half after drainage. Two cases had infection of incisional wound and healed by one month of dressing change. Conclusion By the strict indications selection, correct preoperative treatment for patients with colon injury, it is feasibility for traumatic colon rupture to perform one-stae repair.