左半结肠及直肠损伤的处理

ANALYSIS OF TREATMENT FOR 33 PATIENTS WITH TRAUMA OF LEFT COLON AND RECTUM

目的 :探讨左半结肠及直肠损伤的手术方法。方法 :对 10年来收治的左半结肠及直肠损伤的 33例病人作回顾性研究 ,根据 Flint三级法和 shannon五级法的标准 ,采取不同的手术方法 ,一期手术 2 5例 ,其中单纯修补 19例 ,切除吻合 3例 ,一期修补加近端管状造瘘 3例 ;二期手术 8例 ,其中外置修补 2例 ,造口术 6例。结果 :一期手术 2 5例 ,无并发症和死亡 ,平均住院 15 d,二期手术 8例 ,发生盆腔脓肿 3例 ,经保守治愈 2例 ,死于感染性休克 1例。平均住院 31.5 d。结论 :采取现代外科的一些手段 ,对左半结肠及直肠损伤的病人 ,如果病例选择合理 。

Objective:To explore the surgical methods of trauma of left colon and rectum Methods:33 patients with trauma of left colon and rectum were studied retrospectively The study lasted for 10 years According to Flint's and Shannon's classification,we made the choice of intervention The first phase operation was performed on 25 patients,including primary repair(19 cases), resection and anostomosis(3 cases) And 3 cases had simple repair and colostomy with a mushroom tube in proximity of injury site The second phase operation was performed on 8 patients Colostomy was performed on 6 patients,and exteriorized repair of colon injures(ERCI) on 2 patients Results:There was no complications in primary operation The average hospitalizing time was 15 days 3 of 8 patients after colostomy suffered from pelvic abscess The average hospitalizing time was 31 5 days Conclusion: If patients were selected carefully and proper operation was performed,it is possible to broaden the indication of phase operation