中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2009年
8期
44-45,47
,共3页
肠套叠%肠切除%肠吻合
腸套疊%腸切除%腸吻閤
장투첩%장절제%장문합
Indigitation%Intestinal excision%Intesinal anastomosis
目的 探讨手术治疗肠套叠并肠切除一期吻合术的可行性及近远期效果.方法 于2000年1月至2008年6月收治的78例肠套叠手术复位后合并肠坏死、肠穿孔者72例和继发性肠套叠6例,行肠切除一期端端吻合术,并对其近远期效果进行临床分析.结果 78例中合并肠坏死而无穿孔者48例,合并肠穿孔者30例,合并梅克尔憩室者3例,合并过敏性紫癜致肠壁血肿者2例,合并肠壁淋巴瘤者1例.结肠切除结肠端端吻合26例,回肠切除回肠端端吻合38例,回盲部及部分结肠切除回结端端吻合14例.78例患儿术后恢复良好.76例伤口一期愈合,无肠瘘、肠狭窄及死亡病例.术后随访3个月～9年,其中12例较术前有明显稀便情况,1例术后5 d刀口感染经换药再次缝合后痊愈,1例术后6 d合并肺炎及切口处肌层断开出现腹壁疝,1例术后6个月发生粘连性肠梗阻经再次手术松解粘连带而痊愈.结论 对于肠套叠合并肠壁血运障碍或有器质性病变者可行肠切除一期吻合术,一般不需要考虑肠造瘘或肠管旷置,近远期无明显并发症.
目的 探討手術治療腸套疊併腸切除一期吻閤術的可行性及近遠期效果.方法 于2000年1月至2008年6月收治的78例腸套疊手術複位後閤併腸壞死、腸穿孔者72例和繼髮性腸套疊6例,行腸切除一期耑耑吻閤術,併對其近遠期效果進行臨床分析.結果 78例中閤併腸壞死而無穿孔者48例,閤併腸穿孔者30例,閤併梅剋爾憩室者3例,閤併過敏性紫癜緻腸壁血腫者2例,閤併腸壁淋巴瘤者1例.結腸切除結腸耑耑吻閤26例,迴腸切除迴腸耑耑吻閤38例,迴盲部及部分結腸切除迴結耑耑吻閤14例.78例患兒術後恢複良好.76例傷口一期愈閤,無腸瘺、腸狹窄及死亡病例.術後隨訪3箇月～9年,其中12例較術前有明顯稀便情況,1例術後5 d刀口感染經換藥再次縫閤後痊愈,1例術後6 d閤併肺炎及切口處肌層斷開齣現腹壁疝,1例術後6箇月髮生粘連性腸梗阻經再次手術鬆解粘連帶而痊愈.結論 對于腸套疊閤併腸壁血運障礙或有器質性病變者可行腸切除一期吻閤術,一般不需要攷慮腸造瘺或腸管曠置,近遠期無明顯併髮癥.
목적 탐토수술치료장투첩병장절제일기문합술적가행성급근원기효과.방법 우2000년1월지2008년6월수치적78례장투첩수술복위후합병장배사、장천공자72례화계발성장투첩6례,행장절제일기단단문합술,병대기근원기효과진행림상분석.결과 78례중합병장배사이무천공자48례,합병장천공자30례,합병매극이게실자3례,합병과민성자전치장벽혈종자2례,합병장벽림파류자1례.결장절제결장단단문합26례,회장절제회장단단문합38례,회맹부급부분결장절제회결단단문합14례.78례환인술후회복량호.76례상구일기유합,무장루、장협착급사망병례.술후수방3개월～9년,기중12례교술전유명현희편정황,1례술후5 d도구감염경환약재차봉합후전유,1례술후6 d합병폐염급절구처기층단개출현복벽산,1례술후6개월발생점련성장경조경재차수술송해점련대이전유.결론 대우장투첩합병장벽혈운장애혹유기질성병변자가행장절제일기문합술,일반불수요고필장조루혹장관광치,근원기무명현병발증.
Objective To explore the feasibility and long and short term effect of the first stage anastomosis of indigitation excision of 78 cases. Methods After indigitation excision operation, 72 chil-dren among 78 patients accepted from January 2000 to June 2008 suffered from intercurrent intestines pu-trescence and intestinal perforation, while the left 6 patients suffered from secondary affection. They were treated with first stage anastomosis of end to end intestinal excision. Clinical analysis was made for the long and short term effects. Results Forty -eight children among total 78 cases suffered from intercurrent intestines putrescence without intestinal perforation, 30 eases from intestinal perforation ,3 cases from Meek-el's diverticulum,2 cases from allergic purpura incurred intestinal wall hematoma, 1 cases from intestinal wall lymphoma. 26 children received operation of colon excision and end to end anastomosis ,38 received il-eum or part excision and ileum end to end anastomosis, 14 received cecum and part of colon excision and end to end anastomosis. All 78 patients recovered very well after operation, among which 76 cases healed by first intention, and there were no intesninal fistula,intesninal stricture and dying cases happened. Through random visits to the patients three months to nine years after the operation, we found that: 12 of them had evident loose bowel movement compared with before; 1 case was treated with another suture because the cut was infected five days after the operation;1 case happened with muscle break and ventral hernia six days af-ter the operation;1 ease received another operation for loosening because of adhesive intestinal obstruction six months after the operation and recovered very well. Conclusions Patients with severe indigitation and intercurrent intestinal wall blood movement obstruction or organic pathological changes can be treated with intesninal excision for anastomosis by first intention without regarding enterostomy or exclusion of intesninal fistula. In a long or short period after the operation, there are no syndromes.
