腹部术后腹内疝致急性肠梗阻的诊治体会(附26例报道)

The clinical diagnosis and treatment of pseudohernia-induced intestinal obstruction following abdominal surgery:A report of 26 cases

目的 探讨腹内疝致急性肠梗阻的术前诊断和处理对策。方法 回顾性总结 1985～2 0 0 0年收治的 2 6例腹内疝患者的诊断和处理 ,并比较早期和延迟手术其肠坏死的发生率及术后并发症。结果 17例施行了坏死肠段切除肠吻合术 ,另 9例分别采用束带松解和系膜裂孔缝补术。比较有无肠坏死与手术时间早晚的结果有显著性差异 (P <0 .0 1)。 2 5例治愈出院 ,1例术后死于MSOF。结论 腹内疝致急性肠梗阻术前诊断困难 。

Objective To evaluate the preoperative diagnosis and treatment of the pseudohernia induced intestinal obstruction.Methods The clinical diagnosis and treatment of 26 patients with internal pseudohernia from 1985 to 2000 were retrospectively analyzed, and the incidence of the internal necrosis and complications after early or delay surgical operation was compared.Results 17 cases received enterecotomy and the remaining 9 cases loosened adhensive band and sutured splits in the mesentery, respectively. The outcome was significant difference by comparing early or delay surgical operation with occurrence of the intestinal necrosis ( P < 0.01 ). 25 patients were cured but 1 died from MSOF. Conclusions The preoperative diagnosis of the pseudohernia induced intestinal obstruction is difficulty. Early diagnosis and operation is the key to avoid the occurrence of intestinal necrosis and postoperative complications.