小肠内置管排列术治疗肠梗阻35例分析

Intestinal intubation plication in treating intestinal obstruction:analysis of 35 cases

目的 探讨小肠内置管排列术的临床疗效。方法 对 1996～ 2 0 0 3年采用改良的White手术 ,即小肠内置管排列术治疗病情较为复杂的肠梗阻 35例 ,包括 19例急症手术者。主要原发病为肠粘连和小肠炎性肠病等。结果 随访时间为 1个月至 3年 ,远期有效率为 96 7% (2 9/ 30 ) ,主要并发症为肠漏 (2 5 7% )、低血容量性休克(5 7% )和膀胱损伤 (5 7% )。结论 小肠内置管排列术是治疗复杂性肠梗阻的有效方法 ,正确选择适应证和积极的营养支持有助于减少并发症。肠功能衰竭的机制和诊治方法有待于深入研究。

Objective To evaluate the clinical effect of intestinal intubation plication(IIP). Methods 35 cases of complicated intestinal obstruction were treated with IIP (modified White operation),including 19 cases with indications of emergency operation.Their main primary causes were adhesions and inflammatory intestinal diseases.Results The follow-up ranging from 1 month to 3 years showed that the long-term effective rate was 96.7% (29/30),with the main complications being intestinal leakage (25.7%),hypovolemic shock (5.7%) and bladder injury (5.7%).Conclusion IIP is effective for the treatment of complicated intestinal obstruction.The complications will be reduced if both selection of operative indications and nutritional support are performed.The mechanism,diagnosis and treatment of intestinal functional failure need further research.