CAJ | 학술논문

目的探讨先天性巨结肠术后非计划二次手术的原因,提高医疗技术水平,降低非计划二次手术率.方法选择郑州大学第三附属医院小儿外科2010年1月至2013年1月期间行巨结肠治疗术的病例资料526例,其中13例术后因各种原因非计划二次手术,对其进行回顾性分析,探讨先天性巨结肠非计划二次手术的原因.结果非计划二次手术率为2.5％,非计划二次手术原因包括粘连性梗阻(2例)、黏膜脱垂(2例)、小肠结肠炎(2例)、便秘复发(2列)、肠管回缩(1例),肠瘘(1例),出血(1例)、内疝形成(1例),切口裂开(1例).结论先天性巨结肠非计划二次手术的原因既有其本身并发症的因素,亦有医源性因素,充分的术前准备、全面的术前讨论、术中仔细探查、严格按照规范谨慎操作,提高技术水平,是降低非计划二次手术率的关键.
목적 탐토선천성거결장술후비계화이차수술적원인,제고의료기술수평,강저비계화이차수술솔.방법 선택정주대학제삼부속의원소인외과2010년1월지2013년1월기간행거결장치료술적병례자료526례,기중13례술후인각충원인비계화이차수술,대기진행회고성분석,탐토선천성거결장비계화이차수술적원인.결과 비계화이차수술솔위2.5％,비계화이차수술원인포괄점련성경조(2례)、점막탈수(2례)、소장결장염(2례)、편비복발(2렬)、장관회축(1례),장루(1례),출혈(1례)、내산형성(1례),절구렬개(1례).결론 선천성거결장비계화이차수술적원인기유기본신병발증적인소,역유의원성인소,충분적술전준비、전면적술전토론、술중자세탐사、엄격안조규범근신조작,제고기술수평,시강저비계화이차수술솔적관건.
Objective To investigate the causes of congenital megacolon unplanned secondary surgery,improve the level of diagnosis and treatment and reduce the rate of unplanned secondary surgery.Methods From Jan.2010 to Jan.2013,526 cases of congenital megacolon in department of pediatric surgery,the third affiliated hospital of Zhengzhou university were chose.Among them,13 patients had unplanned secondary surgery due to various reasons.Through respective analysis of the 13 cases,the causes of congenital megacolon unplanned secondary surgery were investigated.Results The rate of unplanned secondary surgery was 2.5％.The causes of congenital megacolon unplanned secondary surgery were as follows:adhesive intestinal obstruction (2 cases),intestinal mucosa prolapse (2 cases),enterocolitis (2 cases),recurrent constipation (2 cases),insufflate retraction (1 case),intestinal fistula (1 case),postoperative bleeding (1 case),internal hernia formation (1 case),incision dehiscence (1 case).Conclusions The causes of congenital megacolon unplanned secondary surgery were its own complications and iatrogenic factors ; Sufficient preoperative preparation,comprehensive preoperative discussion,intraoperative careful examination,carefully operation in strict accordance with the regulation,improve the level of technology,is the key to reduce unplanned secondary surgery.