9例结石性肠梗阻的诊断与治疗

Reearch on the stone intestinal's diagnosis and treatment

目的 探讨结石性肠梗阻的诊断及治疗。方法 比较腹部平片和B超的术前诊断率。随访患者以了解不同手术方法的得失。结果 腹部平片术前诊断率为22％,辅以B超则上升为66％。4例Ⅰ期手术和3例Ⅱ期手术患者无死亡。无胆管炎发作。结论 仅靠腹部平片易漏诊,辅以B超则能提高术前诊断率。争取回期手术切除胆囊、闭合胆肠瘘,如有困难,则动员患者6-8周后Ⅱ期手术。

Objective To explore the diagnosis and treatment of gallstone ileus. Methods The diagnostic rate of preoperative abdominal X - ray and B - ultrasonic examination was compared. The advantages and disadvantages of different procedures were compared. Results The diagnostic rate of preoperative abdominal X - ray examination was 22% and it was improved to 66% when canbined with the B- ultrasonic examination. 4 patients who received primary operation and 3 patients who received secondary operation recovered better and no complication of gall vessel. Conclusions B - ultrasonic examination can improve the preoperative diagnostic rate of gallstone ileus. It is better to resect the gall bladder in primary operation and closing the gall - intestine vessel. If it is difficult, performing the secondary operation within six to eight weeks shoud be suggested.