CAJ | 학술논문

目的：对粪石性结肠穿孔（SPC）的临床特点进行系统评价。方法采用电子文献数据库和网络引擎两种方法，检索关于SPC的病例报道，进行系统评价。结果最后共纳入54篇文献，其中中文文献15篇，英文文献39篇，共包括91例病例，其中男44例，女47例；年龄4～106岁，平均63.9岁，＞60岁者占63.7％（58/91）。71例病例有排便情况的描述，其中有慢性便秘史者62例（87.3％）。80例病例有腹痛起始部位的描述，其中全腹部30例（37.5％），下腹部26例（32.5％）。63例病例有是否发热的描述，其中发热31例（49.2％）。62例病例术前行立位腹部平片检查，其中6例术前明确诊断，术前诊断率为9.7％；29例病例术前行腹部CT检查，其中16例术前明确诊断，术前诊断率为55.2％。结论 SPC虽然少见，但在急腹症的诊断和鉴别诊断中应常规考虑，对于合并慢性便秘等的老年病例，出现不明原因腹痛时要警惕SPC的可能；腹部CT可作为首选检查。
목적：대분석성결장천공（SPC）적림상특점진행계통평개。방법채용전자문헌수거고화망락인경량충방법，검색관우SPC적병례보도，진행계통평개。결과최후공납입54편문헌，기중중문문헌15편，영문문헌39편，공포괄91례병례，기중남44례，녀47례；년령4～106세，평균63.9세，＞60세자점63.7％（58/91）。71례병례유배편정황적묘술，기중유만성편비사자62례（87.3％）。80례병례유복통기시부위적묘술，기중전복부30례（37.5％），하복부26례（32.5％）。63례병례유시부발열적묘술，기중발열31례（49.2％）。62례병례술전행립위복부평편검사，기중6례술전명학진단，술전진단솔위9.7％；29례병례술전행복부CT검사，기중16례술전명학진단，술전진단솔위55.2％。결론 SPC수연소견，단재급복증적진단화감별진단중응상규고필，대우합병만성편비등적노년병례，출현불명원인복통시요경척SPC적가능；복부CT가작위수선검사。
ObjectiveToevaluatesystematicallytheclinicalfeaturesofstercoralperforationofcolon(SPC).Meth-ods We searched bibliographic data bases and network engines for reports on SPC cases .Results A total of 54 literatures were enrolled, 15 in Chinese, 39 in English, including 91 cases (44 males, 47 females, aged 4 to 106 years, averagely 63.9 years old, those aged>60 years accounting for 63.7%).There was description about defecation in 71 cases, thereinto 62 (87.3%) had chronic constipation history; There was description about the initial site of abdominal pains in 80 cases, 30 (37.5%) had pains in whole abdomen, 26 (32.5%) in lower abdomen.There was description about fever in 63 cases, 31 (49.2%) had fever.Sixty-two patients had preoperative erect abdominal plain , and 6 (9.7%) had definite diagnosis before operation; 29 had abdominal CT before operation , and 16 (55.2%) had definite diagnosis .Conclusion SPC is rare, but it needs conven-tional consideration in diagnosis and differential diagnosis of acute abdomen . For elderly combined with chronic constipation , SPC is possible when unexplained abdominal pains appear .Abdominal CT can be the first choice .