CAJ | 학술논문

目的：探讨胆结石性肠梗阻的诊断和治疗方法。方法2000年5月至2013年12月共收治结石性肠梗阻患者17例，回顾性资料显示该病术前诊断困难，围手术期治疗棘手，17例患者均系较大胆结石造成小肠梗阻，空肠梗阻5例，回肠梗阻12例。结果所有患者均治愈出院，平均住院日18．3 d。术后13例（76．5％）患者出现生命征（血压、血氧饱和度、心率等）不稳定；14例患者（82．4％）血电解质平衡紊乱，17例（100％）患者术后1周内白细胞、C反应蛋白升高；术后住院期间有3例（17．6％）患者腹腔内感染，加强抗感染治疗后治愈；出院后随访期内3例（17．6％）患者出现粘连性不全肠梗阻，对症处理后好转；未出现吻合口漏及远期营养不良等严重并发症；3年随访期内未出现因手术造成的死亡病例。结论胆结石性肠梗阻的诊断困难，手术是确诊的方法，也是治疗的主要手段。
목적：탐토담결석성장경조적진단화치료방법。방법2000년5월지2013년12월공수치결석성장경조환자17례，회고성자료현시해병술전진단곤난，위수술기치료극수，17례환자균계교대담결석조성소장경조，공장경조5례，회장경조12례。결과소유환자균치유출원，평균주원일18．3 d。술후13례（76．5％）환자출현생명정（혈압、혈양포화도、심솔등）불은정；14례환자（82．4％）혈전해질평형문란，17례（100％）환자술후1주내백세포、C반응단백승고；술후주원기간유3례（17．6％）환자복강내감염，가강항감염치료후치유；출원후수방기내3례（17．6％）환자출현점련성불전장경조，대증처리후호전；미출현문합구루급원기영양불량등엄중병발증；3년수방기내미출현인수술조성적사망병례。결론담결석성장경조적진단곤난，수술시학진적방법，야시치료적주요수단。
Objective To investigate the diagnosis and treatment of calculous ileus. Methods The clinical data of 17 patients with calculous ileus treated from 2000 May to 2013 December were retrospectively analyzed, showing the difficulty of preoperative diagnosis and perioperative management of such disease .Of the 17 patients with intestinal obstruction casused by huge calculous ileus, 5 had jejunal obstruction and 12 had intestinal obstruction. Results All the patients were cured, and the average hospitalization was 18.3 days.After operation 13 patients (76.5%) had unstable vital signs, including blood pressure, oxygen saturation, and heart rate, whereas 14 patients (82.4%) had blood electrolyte balance disorder.All of the 17 patients (100%) had increased white blood cells and C reactive protein within 1 week after operation.In this series, 3 patients had abdominal infection (17.6%) cured by anti-infection treatment, 3 patients (17.6%) had incomplete adhesive intestinal obstruction, but no leakage and long-term malnutrition.No death occurred during a 3-year follow-up. Conclusion It is difficult to diagnose calculous ileus before operation, and surgical treatment is effective.