【摘要】 目的:分析腹膜后间位结直肠穿孔的临床特点。方法:回顾性分析本院2008年1月至2018年1月腹膜后间位结直肠穿孔患者53例的临床资料,按穿孔解剖位置分为左半结肠组(n=30)和右半结肠组(n=23),分析两组患者的临床特点。结果:左半结肠组患者间位结直肠穿孔的病变类型中肿瘤占比最高,为53.3%(16/30);右半结肠组患者病变类型中肿瘤及炎性穿孔占比最高,均为39.1%(9/23)。两组肿瘤性穿孔的病理类型均以腺癌为主,肿瘤分期以Dukes C为主。两组患者术后并发症以肠瘘、切口感染、肺部感染多见,左半结肠组并发症发生32例次、右半结肠组为15例次,两组患者并发症发生率比较差异有统计学意义(P=0.037)。左半结肠组和右半结肠组患者死亡率分别为6.7%(2/30)、4.3%(1/23),组间比较差异无统计学意义(P=0.715)。结论:腹膜后结直肠穿孔临床诊断困难,常导致严重感染,预后差,并发症发生率高,死亡风险大,一旦确诊应尽早手术治疗。更多还原

【Abstract】 Objective:To summarize the clinical features of retroperitoneal colorectal perforation.Methods:The clinical data of 53 patients with retroperitoneal colorectal perforation who stayed in our hospital between January 2008 and January 2018 were retrospectively analyzed.According to the anatomical location of the perforation,they were divided into the left semicolon group(n=30) and the right semicolon group(n=23).The clinical features of the two groups of patients were analyzed.Results:Among the causative lesions of retroperitonieal colorectal perforation,tumor was the most common factor in the left semicolon group,accounting for 53.3%(16/30) of the cases,compared with tumor and inflammation in the right semicolon group[each accounting for 39.1%(9/23)].The pathological types of perforation-causing tumor in the both groups were predominated by adenocarcinoma,and mostly in Dukes stage C.The postoperative complications in the two groups were frequently intestinal fistula,wound infection,and pulmonary infection,leading to 32 cases in the left semicolon group and 15 in the right semicolon group with significant between-group difference(P=0.037).The mortality rates in the left and right semicolon groups were 6.7%(2/30) and 4.3%(1/23),respectively,with no significant difference between two groups(P=0.715).Conclusion:Retroperitoneal colorectal perforation is difficult to diagnoze in clinical setting,and often leads to serious infection,poor prognosis,high incidence of complications,and high risk of death.Surgical treatment should be performed early when a diagnosis is determined.更多还原