摘要
目的探讨一期修补皮下埋置术在结肠损伤手术治疗中的临床效果及可行性。方法对我院1998年2月至2008年12月间收治19例结肠损伤行一期修补皮下埋置术患者的临床资料进行分析。结果19例病人中腹部刀刺伤11例,腹部闭合性损伤4例,盆腔手术损伤2例,纤维结肠镜检查损伤2例。损伤程度按美国OIS分级,I级6例、Ⅱ级8例、Ⅲ级2例,Ⅳ级2例、V级1例。19例病人手术时间2.1-4.5h,平均2.5 h。住院时间4-55 d,平均19 d。19例患者中,1例合并胸部损伤者术后4 d出现呼吸窘迫综合征,死亡;3例术后5-8 d出现肠瘘,换药46-50 d后痊愈;2例发生切口感染及皮下脂肪液化,换药7-10 d后愈合。余病例均一期愈合。结论一期修补皮下埋置术在结肠损伤手术中具有一定的可行性,可作为一种术式选择。
Objective To evaluate the effect of primary repair and subcutaneous placement in the treatment of colon injuries.Methods The clinical data of 19 colon injuries cases operated with primary repair and subcutaneous placement from February 1998 to December 2008 were retrospectively analyzed.Results Among 19 cases of colon injuries,11 were injured by stab,4 by contuse,2 by pelvic surgery,and 2 by iatrogenic colonoscopy.With OIS ratings of colon injury,6 cases were included in classⅠ,8 in classⅡ,2 in classⅢ,1 in classⅣ,and 1 in class V.The operation time was 2.1-4.5 h with the mean of 2.5 h,the inpatient time was 4-55 days with the average of 19 days.All cases were operated by primary repair or anastomosis after partial colectomy,and subcutaneous placement.One case complicated with serious thorax injury died four days after operation as a result of acute respiratory distress syndrome.Fistula occurred in three case complicated with traumatic shock of liver rupture,and recovered 46-50 days later after drainage without peritonitis.Two cases were found incision infection and fat necrosis. The others incisions healed by first attention.Conclusion It is clinically feasible to perform primary repair and subcutaneous placement in the surgical management of colon injuries.
出处
《海南医学》
CAS
2009年第S6期199-201,共3页
Hainan Medical Journal
关键词
结肠损伤
手术方式
一期修补
皮下埋置
Colon injury
Surgical procedures
Primary repair
Subcutaneous placement
