CAJ | 학술논문

目的总结空肠多发憩室导致肠梗阻的诊断与治疗经验.方法对天津市第一中心医院自2001年1月至2012年8月收治的18例空肠多发憩室导致肠梗阻患者的临床资料进行回顾性分析.结果本组18例患者均出现腹痛、腹胀,5例合并恶心、呕吐,2例合并发热.立位腹部X线平片均可见小肠肠管胀气及气液平面.5例合并贫血,平均血红蛋白(9.5±1.0)g/L.15例行腹部B超检查,8例未见明显异常,7例腹腔肠管扩张.9例行腹部CT检查,均报告腹腔内肠管扩张伴气液平面,其中1例不除外肠系膜扭转.所有患者在保守治疗无效后均行手术治疗,术中及术后病理检查证实为空肠多发憩室.术后随访时间为2～25个月,中位随访时间为16.3个月,1例患者死亡,其余患者均健康存活.结论空肠多发憩室引起的肠梗阻临床少见,术前明确诊断率低,切除受累段肠管可获得治愈.
목적 총결공장다발게실도치장경조적진단여치료경험.방법 대천진시제일중심의원자2001년1월지2012년8월수치적18례공장다발게실도치장경조환자적림상자료진행회고성분석.결과 본조18례환자균출현복통、복창,5례합병악심、구토,2례합병발열.립위복부X선평편균가견소장장관창기급기액평면.5례합병빈혈,평균혈홍단백(9.5±1.0)g/L.15례행복부B초검사,8례미견명현이상,7례복강장관확장.9례행복부CT검사,균보고복강내장관확장반기액평면,기중1례불제외장계막뉴전.소유환자재보수치료무효후균행수술치료,술중급술후병리검사증실위공장다발게실.술후수방시간위2～25개월,중위수방시간위16.3개월,1례환자사망,기여환자균건강존활.결론 공장다발게실인기적장경조림상소견,술전명학진단솔저,절제수루단장관가획득치유.
Objective To evaluate the diagnosis and therapy of intestinal obstruction caused by multiple jejunal diverticula.Methods Clinical data of intestinal obstruction caused by multiple jejunal diverticula in 18 cases admitted from Jan 2001 to Aug 2012 were analyzed retrospectively.Results All patients experienced the symptoms of abdominal pain and abdominal distension,5 cases experienced nausea and vomit,2 cases had a fever.Plain abdominal X-ray series demonstrated distension of small bowel and multiple air-fluid levels,5 cases with anemia,the average value of hemoglobin was (9.5 ± 1.0) g/L,B-ultrasonography revealed bowel dilatation in 7 out of 15 cases,9 cases underwent abdominal computed tomography and all had positive sign of small bowel distension and multiple air-fluid levels,mesenteric volvulus was suspected in 1 case.All patients underwent laparotomy,the diagnosis of multiple jejunal diverticula were confirmed clinically and by the pathology.In a follow-up ranging from 2 to 25 months,1 case died,the others were symptoms free.Conclusions Multiple jejunal diverticula was a less common disorder,occurring mainly in old man,with a low preoperative definite diagnosis.Resection of affected intestinal segment with primary anastomosis results in satisfactory prognosis.