结直肠损伤35例手术治疗的回顾性分析

目的:探讨结直肠损伤手术处理的经验。方法:对35例结直肠损伤患者的临床资料进行回顾性分析。结果:35例患者均行手术治疗。治愈34例(92.1%),死亡1例(7.9%),术前确诊仅11例(31.4%)。一期单纯缝合肠修补术11例,肠切除吻合术13例,共计24例,占68.6%;二期造口或外置术11例,占31.4%。结论:结直肠损伤早期易误诊。多数结肠和腹膜内直肠损伤可一期手术,应配合围手术期正确使用抗生素尤其是甲硝唑。通过早期确诊、手术治疗及控制感染可提高临床疗效。

Surgical treatment of 35 cases of colorectal injuries

Objective To explore the characteristics and management of colorectal injuries.Method Clinical data of 35 patients with colorectal injuries were retrospectively reviewed.Results The 35 cases proceeded surgical operation,34 cases（92.1%） were cured completely,and 1 case died（7.9%）.Only 11 cases（31.4%） were preoperatively diagnosed.One stage repair of colon or one stage anastomosis after excision of injuried colon were performed on 24 cases（68.6%）,and 11 cases（31.4%） were treated with ostomy or external intestinal surgery.Conclusion Colorectal injuries were easily misdiagnosed early.In most of the cases with injury of colon or intraperitoneal segment of rectum,primary repair or anastomosis can be carried out safely.Rational use of perioperative antibiotics is necessary.The early stage diagnosis,operation and infection control can improve the effection of the treatment.