【摘要】 目的探讨结直肠损伤处理的经验。方法对 86例结、直肠损伤患者的临床资料进行回顾性分析。结果 86例结、直肠损伤均经手术治疗 ,并发其他脏器损伤 6 1例 ,一期单纯修补或切除吻合术占 88% (76 / 86 ) ,无肠瘘发生。二期肠造口或外置术占 1 2 %。死亡率为 1 0 % ,近 1 0年来已下降为 4 %。结直肠损伤的主要死亡原因为多发伤、出血性休克与严重感染。结论结、直肠损伤以钝性闭合伤为主 ,一期手术应为首选 ;二期手术仅适用于结肠重度损伤、腹腔重度污染、全身病情严重需行“损伤控制手术”和直肠中、下段损伤者更多还原

【Abstract】 Objective To study the current management strategy for colorectal injuries. Methods The clinical data of 86 consecutively admitted patients with penetrating colorectal injuries were retrospectively reviewed. Results Most injuries were of closed type. Iatrogenic colon injury accounted for 14%. There were 61 patients (71%) associated with other abdominal organ injuries. Operations were performed in all patients. Seventy six patients were treated with primary repair or resection and anastomosis, and 10 with diverting colostomy. In recent 10 years mortality rate dwindled from 10% to 4%(2/46). Mortality was most often caused by hemorrhagic shock, associated organ injuries or severe secondary infection. Conclusions Most colorectal traumas are blunt closed type in China. Primary repair or resection and anastomosis at the time of initial exploration is most often used for colorectal injuries. Indications for diverting colostomy are severe shock, heavy intra abdominal contamination, poor condition, and rectal injury. Fecal peritonitis should be effectively prevented and treated.更多还原