城市和农村急性肠梗阻的病因及诊治分析

Analysis of Etiology, Diagnosis and Treatment of Acute Intestinal Obstruction in Different Groups of City and Countryside

目的分析城市和农村急性肠梗阻的病因演变及诊治方法.方法回顾分析收治的451例急性肠梗阻患者.居住在城市的为城市组,居住在农村的为农村组.结果451例中,城市组258例,农村组193例.全组共有结直肠肿瘤157例,肠粘连152例,斜疝37例,其他肿瘤腹腔广泛转移30例,肠扭转16例,原因不明21例,其他原因38例.结论肿瘤和肠粘连是城市和农村肠梗阻的主要病因;斜疝和小肠扭转引起的急性肠梗阻农村组高于城市组;加强术前诊断,选择最佳治疗方法是降低病死率和并发症的关键.

Objective To analyze the etiology evolution, diagnosis and treatment of acute intestinal obstruction in different groups of city and countryside. Methods 451 cases of acute intestinal obstruction admitted in our department from February 1992 to December 2001 were analyzed retrospectively. Patients in city belonged to city group and the ones in countryside belonged to countryside group. Results Among 451 cases, 258 cases belonged to the city group while 193 cases belonged to the countryside group. There were 157 cases of colon cancer or rectal cancer, 152 cases of adhesion, 37 cases of oblique hernia, 30 cases of cancer metastasis, 16 cases of volvulus of intestine and 59 cases of other causes. Conclusion Tumor and adhesion are the main causes of acute intestinal obstruction in city and countryside groups. Oblique hernia and enteric volvulus caused acute intestinal obstruction in countryside group is higher than those of city group. It is the key to enhance preoperative diagnosis and choose the best therapy for decreasing morbidity and mortality.