摘要
目的:总结急性肠梗阻的病因学类型和总体病死率,探索手术治疗前合理的保守治疗时间。方法:回顾性分析了华西医院1995年至2002年的住院病人病历,分类统计各类病因,并分析病死率与手术前保守治疗间期的相关性。结果:共纳入705例急性肠梗阻病例,其中71.1%病变部位在小肠,82.6%为单纯性肠梗阻。最常见病因为粘连(62.0%),肿瘤次之(23.7%)。56.7%的病例接受外科治疗。总体病死率为1.6%,其中保守治疗组为1.3%,外科治疗组为1.7%。肠坏死发生率随保守治疗间期延长而增高,当绞窄发生超过24 h即可能死亡。结论:与西方相似,在中国同样有病因向粘连性转移的流行病学趋势。基于四川大学华西医院经验,近半数的单纯性肠梗阻病例可经保守治疗缓解。保守治疗延长且无缓解趋势的单纯性肠梗阻,或绞窄发生第一个24 h内的病例应接受外科治疗。
Objective： To figure out the etiological factors and overall mortality of the patients with acute intestinal obstruction,and to explore the rational period of conservative therapy before operation.Methods： Medical records of all the patients with acute intestinal obstruction admitted to West China Hospital from 1995 to 2002 were retrospectively reviewed.The etiology of the obstruction was categorized,and the correlation of mortality and time interval between conservative therapy and operation was analyzed.Results： There were 705 patients with acute intestinal obstruction included.There were 71.1% of the obstruction lesions located on the small bowel,and 82.6% of the patients experienced simple obstruction.The most frequent cause was adhesions（62.0%）,and next was neoplasms（23.7%）.There were 57.6% of the patients underwent the surgical treatment.The overall mortality rate was 1.6%,and the mortality rates in conservative therapy and surgical intervention groups were 1.3% and 1.7% respectively.The intestinal necrosis rate was increased gradually with the prolongation of time interval between conservative therapy and operation,and the death might occur 24 hours after strangulation.Conclusion： The epidemiological transition to adhesive obstruction still exists in China,and it is similar to that in Western countries.In our experience,near half of the patients with simple obstruction may achieve palliation by conservative therapy.Surgical intervention is indicated for the patients with prolonged and non-palliated simple obstruction,or strangulation disease within the first 24 hours.
出处
《中西医结合学报》
CAS
2008年第10期1010-1016,共7页
Journal of Chinese Integrative Medicine
基金
国家自然科学基金面上项目(No.30600591)
四川大学华西医院胃肠肿瘤多学科协作项目
关键词
肠梗阻
病因学
预后
病死率
intestinal obstruction, etiology, prognosis, mortality
