中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
9期
969-971
,共3页
大肠%自发破裂%外科手术
大腸%自髮破裂%外科手術
대장%자발파렬%외과수술
Colorectal%Spontaneous rupture%Surgery
目的 分析自发性大肠破裂的病因、病理、诊断、治疗以及预后的相关因素.方法 收集国内近十年报道的自发性大肠破裂病例155例,结合我院2002年以来诊治的自发性大肠破裂病例5例,进行临床相关因素分析.手术方式为破裂修补术5例、破裂修补外置5例、破裂修补+近端结肠造瘘(单腔或双腔)43例、破裂肠管切除吻合+近端肠管造瘘(单或双腔)61例、破裂肠管切除断端双腔造瘘6例、破裂肠管切除吻合5例、破裂肠管直接造瘘9例.余术式表述不详.结果 治愈117例(73.1%,117/160),死亡43例(26.9%,43/160).结论 自发性大肠破裂多发生于老年患者,为少见痛.确诊率低,易延误病情;同时腹腔污染致感染中毒性休克直接危及生命.及时诊断并手术治疗是提高治愈率的关键.
目的 分析自髮性大腸破裂的病因、病理、診斷、治療以及預後的相關因素.方法 收集國內近十年報道的自髮性大腸破裂病例155例,結閤我院2002年以來診治的自髮性大腸破裂病例5例,進行臨床相關因素分析.手術方式為破裂脩補術5例、破裂脩補外置5例、破裂脩補+近耑結腸造瘺(單腔或雙腔)43例、破裂腸管切除吻閤+近耑腸管造瘺(單或雙腔)61例、破裂腸管切除斷耑雙腔造瘺6例、破裂腸管切除吻閤5例、破裂腸管直接造瘺9例.餘術式錶述不詳.結果 治愈117例(73.1%,117/160),死亡43例(26.9%,43/160).結論 自髮性大腸破裂多髮生于老年患者,為少見痛.確診率低,易延誤病情;同時腹腔汙染緻感染中毒性休剋直接危及生命.及時診斷併手術治療是提高治愈率的關鍵.
목적 분석자발성대장파렬적병인、병리、진단、치료이급예후적상관인소.방법 수집국내근십년보도적자발성대장파렬병례155례,결합아원2002년이래진치적자발성대장파렬병례5례,진행림상상관인소분석.수술방식위파렬수보술5례、파렬수보외치5례、파렬수보+근단결장조루(단강혹쌍강)43례、파렬장관절제문합+근단장관조루(단혹쌍강)61례、파렬장관절제단단쌍강조루6례、파렬장관절제문합5례、파렬장관직접조루9례.여술식표술불상.결과 치유117례(73.1%,117/160),사망43례(26.9%,43/160).결론 자발성대장파렬다발생우노년환자,위소견통.학진솔저,역연오병정;동시복강오염치감염중독성휴극직접위급생명.급시진단병수술치료시제고치유솔적관건.
Objective To retrospectively investigate the cause of spontaneous rupture of the large intestine,pathology, diagnosis, treatment and prognosis of the relevant factors. Methods The collection of domestic medical records of 155 cases of spontaneous rupture of the large intestine in last decades,combined with 5 cases collected in our hospital since 2002. All the cases underwent emergency surgery confirmed the preoperative diagnosis of straight,colon rupture in 25 cases. Surgical repair for rupture in 5 cases,rupture of an external repair in 5 cases,rupture of the proximal colostomy repair combined with single or dual-chamber in 43 cases of ruptured bowel resection and anastomosis of the proximal intestine fistula combined with single or dual-chamber in 61 cases ruptured bowel resection stump of dual-chamber fistula in 6 cases, rupture of bowel resection and anastomosis in 5 cases, rupture of intestine directly fistula 9 cases. Surgical presentation in the remained cases were unknown. Results One hundred and seventeen patients cured, 43 cases died. Conclusions Most spontaneous colon rupture occurred in elderly patients,and is rare disease. The diagnosis rate is low and easy to delay in the treatment. Moreover, the intraabdominal infections caused by pollution would leed to a direct life-threatening toxic shock. Therefore, prompt diagnosis and timely surgery is important to improve the cure rate.
