急性肠梗阻69例诊治分析

Etiology analysis on diagnosis and treatment of acute intestinal obstruction:A review of 69 cases

目的 提高对急性肠梗阻的诊断治疗水平。方法 回顾性分析我院急性肠梗阻手术病人的诊断治疗经验。结果 69例病人的主要原发疾患是 :肠粘连 17例 ,肿瘤 2 3例。诊断主要依靠病史和体征以及典型腹部立卧位平片 (90 % )。B超或CT对 3 0 %病人有诊断价值。 69例病人均经手术治疗 ,无手术死亡。结论 急性肠梗阻最常见的原因为肿瘤和粘连。急性肠梗阻的诊断主要靠典型的病史体征 ,以及腹部立卧平片 ,B超或CT。急性肠梗阻保守无效应积极手术。

Objective To investigate the causes of acute intestinal obstruction aquired operation and to summer our diagnostic and therapeutic experience.Method Retrospective study was undertaken.Results Operations were performed on total 69 patients with acute intenstinal obstruction without perioperative death.Most common causes were malignant tumors 23 (33%), adhension 17(25%).The diagnosis mainly depend on typical history, physical examination and plain abdominal radiographs(in 90% patients) while sonography and CT were helpful in 30% patients. Laparotomy was performed on 56 cases after failure of conservative therapy including traditional medicine. Main operations included enterolysis in 18 cases, enterectomy in 14, colonstomy in 9, colonectomy in 13, enterolithotomy in 6.Conclusion Among numerous causes of acute intenstinal obstruction, malignant tumors and adhensions appear to be the most common initial diseases. Typical data from history, physical examination and plain abdominal radiographs are keys to diagnosis and treatment of acute intenstinal obstruction. CT and Sonography are valuable diagnostic procedures in some patients. Active laparotomy and appropriate operation should be considered if conservative therapy has not succeed.