消化道恶性肿瘤术后肠梗阻的原因与处理

目的 分析消化道恶性肿瘤术后发生肠梗阻的原因,探讨再手术的价值.方法 回顾性分析1986年1月至2005年12月经手术治疗的104例术后发生肠梗阻的消化道恶性肿瘤患者的临床资料.结果 恶性肿瘤复发致术后发生肠梗阻者占59.7%(62/104);良性原因占40.3%(42/104).恶性梗阻多在术后1-2年出现,而良性梗阻多发生在术后半年内(71.4%,30/42).42例良性梗阻中有2例因未及时手术而死亡,其余经手术全部解除梗阻;恶性梗阻经手术解除者67.7%(42/62).结论 应提高对消化道恶性肿瘤术后发生肠梗阻原因的分析能力,积极而慎重地手术解除梗阻是有效的治疗方法 .

Causes and management of postoperative bowel obstruction in gastrointestinal malignancies

Objective To investigate the causes and management of postoperative bowel obstruction，and evaluate the reoperation in gastrointestinal malignancies.Methods The clinical data of 104 patients diagnosed as postoperative malignant obstruction and reoperated from January 1986 to December 2005 in our hospital were retrospectively analyzed.The relationship between the causes and clinical features in postoperative bowel obstruction were studied.Results Among 104 patients，62 were caused by malignant recurrence and 42 benign pathological changes.The malignant obstruction was mostly occurred during 1-2 years while the benign almost within 6 months after first radical resection.Foay-two cases of benign obstruction were successfully reoperated，leaving two cases died of delayed surgical intervention. Forty-two of 62 malignant obstruction recovered successfully after surgery.Conclusions Elevated capability of diagnosis in the causes of postoperative malignant obstruction，combined with careful operation，is the key point to ameliorate prognosis effectively.