摘要
目的:探讨术后腹内疝致急性肠梗阻的诊断以及治疗方法。方法:收治术后腹内疝致急性肠梗阻患者48例,回顾性分析其临床资料。进行胃空肠吻合术的患者在手术后横结肠系膜与小肠疝入输入段的空肠形成裂隙导致内疝致急性肠梗阻6例,腹会阴联合直肠癌根治术后患者侧腹壁与降结肠形成间隙导致内疝2例,腹会阴联合直肠癌根治术后盆底筋膜出现裂开导致内疝6例,因各种手术导致腹腔粘连,肠壁、腹腔脏器、腹膜以及肠与肠之间的孔隙导致术后腹内疝致急性肠梗阻34例,所有患者均实行裂孔修补、粘连松解、疝入肠复位,其中16例患者出现肠坏死,实行肠切除吻合手术。结果:经尽早确诊及手术治疗46例患者均治愈出院,2例患者在术后因中毒性休克死亡。结论:腹部手术后腹内疝致急性肠梗阻,病情危险,需及早诊治和手术避免肠坏死及手术并发症的发生,而且CT在术后诊治腹内疝致急性肠梗阻诊治中具有重要意义。
Objective:To explore the diagnosis and treatment of acute intestinal obstruction caused by abdominal hernia after surgery.Methods:48 patients with acute intestinal obstruction caused by abdominal hernia after surgery were selected,and the clinical data were retrospectively analyzed.In the gastrojejunostomy patients,after operation,6 cases of acute intestinal obstruction were due to internal hernia of transverse mesocolon and hernia of the small intestine into the input segment for the jejunum formation;in patients after combined abdominal perineal rectal cancer radical resection,lateral abdominal wall and descending colon for gap formation leaded to internal hernia in 2 cases;after radical resection of abdominal perineal rectal cancer,basin fascia dehiscence leaded to internal hernia in 6 cases;because of all kinds of operation lead to peritoneal adhesions,intestinal wall, abdominal peritoneum and bowel,and intestinal pore leaded to postoperative intra-abdominal hernia and acute intestinal obstruction in 34 cases.All patients were given a hiatus hernia repair,lysis of adhesions,herniated bowel reset,among them,16 patients had intestinal necrosis,they were given intestinal resection and anastomosis operation. Results:Through the early diagnosis and operation treatment,46 patients were cured,and 2 patients were death because of toxic shock after operation. Conclusion:After abdominal surgery,abdominal hernia was easily lead to acute intestinal obstruction,and the condition was dangerous.Diagnosis and operation as soon as possible can avoid intestinal necrosis and complications,and CT had an important significance in the diagnosis and treatment of acute intestinal obstruction caused by abdominal hernia after operation.
出处
《中国社区医师》
2015年第12期51-52,共2页
Chinese Community Doctors
关键词
腹部手术
腹内疝
急性肠梗阻
诊治分析
Abdominal operation
Internal hernia
Intestinal obstruction
Analysis of diagnosis and treatment
