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直肠癌术后早期肠梗阻的临床特点和治疗

The clinical characteristics and treatment of early intestinal obstruction after rectal carcinoma operation

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【作者】 陈正煊陈创奇彭俊生卢砺锋

【Author】 CHEN Zheng xuan, CHEN Chuang qi, PENG Jun sheng, LU Li feng (Department of Gastrointestinal Surgery, The First Affiliated Hospital, Sun Yat sen University of Medical Sciences, Guangzhou 510090, China)

【机构】 中山医科大学附属第一医院胃肠外科!广东广州510080

【摘要】 目的 探讨直肠癌手术后早期肠梗阻的临床特点和手术时机。方法 回顾分析直肠癌手术 40 8例术后早期肠梗阻 2 6例的临床资料。结果  2 1例经手术探查发现以机械性梗阻占多数 (19 2 1) ,手术治愈 18例 ;死亡 3例 ,死亡原因均为延误手术时机造成。非手术治愈 5例。结论 直肠癌术后早期肠梗阻虽有梗阻症状 ,但由于术后诸多因素的影响 ,大多缺乏典型机械性梗阻的临床表现 ,易与术后肠麻痹 ,炎性粘连梗阻相混淆 ,应注意加以鉴别。处理中可先进行适当时间的非手术治疗 ,但非手术治疗未能缓解梗阻症状或反复出现“通而不畅”的现象 ,应警惕是机械性因素引起 ,需再次手术探查

【Abstract】 Objective To investigate the clinical feature and operation timing of early intestinal obstruction(EIO) after rectal carcinoma operation. Methods Retrospective analysis of the clinical data was made for 26 cases of EIO after 408 operations of rectal carcinoma from January 1987 to December 1997 in our hospital. Results Through operative exploration, 19 of 21 cases were found mechanical obstruction. 18 cases were cured by operative therapy, 5 patiects were cured by conservative therapy. 3 cases died because of delayed operation. Conclusions Although there exist obstructive symptoms in the EIO cases after rectal carcinoma operation, most cases lacked typical clinical findings because of the effect of other post operative factors; and easely being confused with paralytic or adhesive obstructions. Non operative therapy is necessary for early postoperative intestinal obstruction. But when the obstructive symptom can not be relieved completely, the possibility of mechanical obstruction should be considered and operative exploration should be performed.

  • 【文献出处】 中国普通外科杂志 ,CHINESE JOURNAL OF GENERAL SURGERY , 编辑部邮箱 ,2000年04期
  • 【分类号】R735.37
  • 【被引频次】17
  • 【下载频次】98
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