-
摘要: 目的:探讨老年人乙状结肠穿孔的临床特点和诊治经验。方法:回顾性分析35例老年人乙状结肠穿孔患者的临床资料。结果:本组35例中,肿瘤性穿孔9例,非肿瘤性穿孔26例。所有患者均行急诊剖腹探查术,术后因感染性休克或多器官功能衰竭死亡13例(37.1%),存活22例(62.9%),术后再发穿孔行二次手术5例,伤口感染8例,伤口裂开行二期缝合2例。结论:老年人群乙状结肠穿孔有时缺乏特异性临床表现,综合分析病史、体征及辅助检查,准确判断手术指征和手术治疗是改善预后的关键。Abstract: Objective: To explore the clinical characteristics and treatment strategy of perforation of the sigmoid colon of elder patients.Method: The clinical data of 35 cases with perforation of the sigmoid colon were analyzed retrospectively.Result: Nine patients have perforation of the sigmoid colon with tumor and twenty-six with non-tumor in all 35 cases.All patients underwent emergent surgical treatment.After operation,13 patients died of septic shock or MODS(37.1%) and 22 cases were cured(62.9%),5 cases underwent reoperation because of reperforation,8 cases got the infection of incisions,2 cases had disruption of the wound requiring reoperation.Conclusion: The perforation of the sigmoid colon without specific clinical manifestations sometimes.To analyseanalyze the case history,medical examination and adjunct examination,combine early diagnosis and appropriate surgical treatment are significant to improve the prognosis.To explore the indications and operation on time is also the key point for improving curative effect.
-
Key words:
- perforation of the sigmoid colon /
- elder patients /
- diagnosis /
- treatment
-
[1] GEORGE G M,FABIAN T C,VOELLER G R,et al.Primary repair of colon wounds[J].Ann Surg,1989,209:728-731.
[2] SHARMA M,AGRAWAL A.Case report:Stercoral sigmoid colonic perforation with fecal peritonitis[J].Indian J Radiol Imaging,2010,20:126-128.
[3] NAM J K,KIM B S,KIM K S,et al.Clinical analysis of stercoral perforation of the colon[J].Korean J Gastroenterol,2010,55:46-51.
[4] 吴在德,吴肇汉.外科学[M].6版.北京:人民卫生出版社,2007:430-430.
[5] 戴观荣,赵为国,邓鉴文,等.非创伤性乙状结肠穿孔18例分析[J].中国普通外科杂志,2007,16(12):1213-1214.
[6] 肖孝银.自发性乙状结肠穿孔18例治疗体会[J].中华现代临床医学杂志,2003,1(6):489-489.
[7] 方法状,王昭南,毛华新.老年结肠穿孔的诊断及急诊处理[J].现代实用医学,2009,21(5):511-518.
[8] 王鹏飞,李佑生,黎介寿.严重腹部损伤的损伤控制性手术[J].肠内和肠外营养,2007,14(5):297-300.
[9] HUANG W S,WANG C S,HSIEH C C,et al.Management of patients with stercoral perforation of the sigmoid colon:report of five cases[J].World J Gastroenterol,2006,12:500-503.
[10] 彭伟.结肠穿孔的手术治疗[J].中国实用医药,2008,3(10):124-125.
计量
- 文章访问数: 202
- PDF下载数: 9
- 施引文献: 0