12例结肠粪性溃疡穿孔诊治分析

目的：探讨结肠粪性穿孔的发病原因、临床特点、诊断和治疗方法。方法回顾性分析广州市第一人民医院2012年1月—2015年1月收治的12例结肠粪性穿孔病人的临床资料。结果本组病人共12例，均因腹膜炎体征行剖腹或腹腔镜探查术，术中根据 Maurer 标准诊断为结肠粪性溃疡穿孔。本组病人术后治愈出院10例，治愈率为83．3％，2例80岁以上病人因感染中毒性休克、多器官功能衰竭分别于术后第2天及第3天在重症监护病房死亡，死亡率为16．7％，术后主要合并症为肺炎（10例，83．3％）及胸腔积液（12例，100％）。结论在临床工作中，了解结肠粪性穿孔发生的危险因素，及时进行有针对性的辅助检查，快速手术干预是降低病死率的关键。

Clinical analysis of stercoral perforation of colon in twelve patients

Objective To explore the causes,clinical characteristics,diagnosis and treatment of stercoral perforation of colon. Methods The clinical data of 1 2 cases of stercoral perforation of colon from Jan 201 2 to Jan 201 5 were retrospective-ly analyzed. Results There were twelve patients who were diagnosed stercoral perforation of colon according to accurate diag-nostic criteria during the open or laparoscopic operation.Of the 1 2 cases,1 0 cases (83.3%)were cured,2 cases (1 6.7%) died because of septic shock and multiple organ failure in the intensive care unit.After operation 1 0 cases (83.3%)had pulmo-nary infection and 1 2 cases (1 00%)had pleural effusion. Conclusion The key of improve the prognosis of stercoral perfora-tion of colon depends on the full understanding of risk factors,proper preoperative examination and prompt surgical procedures.