139例绞窄性肠梗阻的临床诊断与手术处理

Xueying Chen, Rong-lin Yan, Xing Yang, Wen-yuan Guo, Weiyuan Zhang
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摘要

目的:探讨绞窄性肠梗阻的早期诊断及手术方式。方法:回顾性分析我院1975年1月~ 1999年12月收治的139例绞窄性肠梗阻患者的临床资料。结果:术前诊断为绞窄性肠梗阻的患者58例(41.7%),开腹诊断为绞窄性肠梗阻的患者81例(58.3%)。所有患者均行手术治疗,治愈106例,死亡33例。死亡率为23.7%。死亡原因主要为感染性休克、MOF、ARDS及严重的水电解质、酸碱平衡紊乱。结论:绞窄性肠梗阻早期诊断困难。通过仔细分析临床特征和相关检查,可以预防肠坏死。早期手术是最有效的治疗方法。强调术后ICU管理是降低死亡率的关键环节。
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THE CLINICAL DIAGNOSIS AND OPERATION MANAGEMENT OF STRANGULATING INTESTINAL OBSTRUCTION IN 139 CASES
Objective: To investigate the early diagnosis and operative manner of strangulating intestinal obstruction. Methods: The clinical material of 139 patients with strangulating intestinal obstruction from Jan. 1975 to Dec. 1999 was analysed retrospectively. Results: There were only 58 patients(41.7%) were diagnosed as strangulating intestinal obstruction before operation, the other 81 patients(58.3%) were diagnosed at laparotomy. All patients were treated by operation, 106 patients were cured, 33 dead. The mortality was 23.7%. The main cause of death was septic shock、MOF、ARDS and severe disturbance of water-electrolyte、acid-base balance. Conclusion: Early diagnosis of strangulating intestinal obstruction was difficult. Intestine necrosis may be prevented by analysing carefully the clinical features and related examinations. Early operation was the most effective treatment. Emphasized post operative ICU management was the key procedure of decreasing mortality.
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