摘要
目的总结成人小肠扭转的病因、发病机制及早期诊断经验。方法对2009年10月至2012年10月期间摩洛哥赛达特省哈桑二世医院收治的43例小肠扭转患者的临床资料进行回顾性分析。结果本组43例小肠扭转患者中自发性小肠扭转11例,继发性小肠扭转32例,术后腹腔粘连为主要继发原因,有19例(59.4%)。临床表现:早期持续剧烈腹痛40例,频繁呕吐29例,肠型或腹部包块28例。43例小肠扭转均手术,其中22例术前B超确诊。术中见肠坏死16例。治愈37例,死亡6例。结论小肠扭转以继发性为主,术后腹腔粘连是小肠扭转的主要原因;小肠扭转与肠梗阻可互为因果;早期小肠扭转具有腹痛剧烈、呕吐早、症状体征不符等特点,早期诊断以临床为主,B超和CT具有辅助诊断价值;该病起病急,进展快,宜早期手术介入。
Objective To study the etiology, pathogenesis, and diagnosis of small bowel volvulus in adults. Method The clinical data of 43 cases of small bowel volvulus admitted to Hassan 1I Hospital of Settat from October 2009 to October 2012 were analyzed retrospectively. Results There were 11 cases of spontaneous small bowel volvulus. There were 32 cases of secondary small bowel volvulus, of which 19 cases due to postoperative abdominal adhesions. Clinical manifestation： early persistent severe abdominal pain was in 40 cases, frequent vomiting was in 29 cases, intestinal pattern or abdominal mass was in 28 cases. All 43 patients were received surgery, 22 （51.2%） cases were diagnosed by preoperative ultrasonography, small bowel necrosis was found in 16 cases during operation, 37 （86. 0%） patients were cured and 6 （14.0%） patients died. Conclusions Secondary small bowel volvulus is main small bowel volvulus, postoperative abdominal adhesion is major causes of small bowel volvulus, the value of abdominal X-ray in diagnosing is limited. However, ultrasonography and CT are helpful in diagnosing these diseases. Small bowel volvulus and intestinal obstruction can reinforce each other. Early small bowel volvulus is characterized by clinical conditions such as severe abdominal pain, early vomiting signs, and signs not matching the symptoms. Acute onset and rapid progression are the features of small bowel volvulus, surgery should be intervened in early stage.
出处
《中国普外基础与临床杂志》
CAS
2013年第11期1279-1283,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
小肠扭转
发病机制
早期诊断
Small bowel volvulus
Pathogenesis
Early diagnosis
