结肠损伤的诊治体会

目的:探讨结肠损伤的特点及诊治方法,提高早期确诊率和治疗成功率。方法:对我院1996年～2006年期间结肠外伤42例病例的临床资料进行回顾性分析。结果:结肠损伤中刀刺伤占20例(48%),腹部钝挫伤占16例(38%),火气伤4例(10%),医源性损伤占2例(5%);合并腹腔内其他脏器损伤36例。术前诊断腹部空腔脏器损伤12例。全部病例均行手术治疗,其中一期修补或切除吻合36例,一期修补同时行损伤之结肠外置、二期还纳6例。术后死亡1例。结论:结肠损伤以开放性损伤多见,常伴有其他脏器损伤。治疗上强调早期手术,探查全面,防止遗漏,一期修补或切除吻合对绝大多数结肠损伤是安全可靠的,结肠外置手术可部分取代结肠造瘘手术。

Diagnosis and treatment of colon injury

Objective: To explore the clinical characteristics and surgical approach in patients suffering from colon injuries.Methods: The clinical data of 42 cases of colon injury in our hospital from 1996 to 2006 were analysed retrospectively.Results: Of 42 cases,47% were injured by stab,38% by contuse,5% by iatrogenic injury.36 cases were complicated by multiple organ injuries.12 patients were diagnosed preoperatively.All cases were operated.36 cases were performed by one stage repair or anastomosis after excision of colon injury.6 patients were performed by exteriorizing repair and secondary returning operation.One case was died after operation.Conclusion: Colon injury was mostly caused by abdominal puncture,always complicated by multiple organ injuries.We emphasize early operation and comprehensive exploration of abdominal.One stage repair or anastomosis after excision of colon injury is recommended for most patients with colon injury.Colon exteriorizing repair takes partly the place of colostomy.