109例绞窄性肠梗阻临床诊断与治疗

目的：探讨绞窄性肠梗阻的早期诊断和合理治疗方法。方法：回顾分析1988年1月至2002年10月收治的109例绞窄性肠梗阻的临床资料。结果：全组均经手术治疗，术前确诊绞窄性肠梗阻56例(51．4％)，腹痛性质、压痛包块、腹水征、肌紧张、腹平片(或腹透)、CT和B超是早期确诊绞窄性肠梗阻的主要依据；其余53例(48．6％)均在剖腹探查时确诊。治愈101例(92．7％)，死亡8例，死亡率(7．3％)。主要死亡原因为感染性休克、MOF、ARDS。结论：绞窄性肠梗阻早期诊断困难，应动态观察临床表现和辅助检查，正确把握手术时机，预防肠坏死发生，早期及时采取正确的手术方式是降低死亡率的关键。

THE CLINICAL DIAGNOSIS AND MANAGEMENT OF STRANGULATING INTESTINAL OBSTRUCTION IN 139 CASES

Objective:To investigate the early diagnosis and operative manner of strangulating intestinal obstruction.Methods:The clinical material of 109 patients with strangulating intestinal obstruction from January 1988 to October 2002.Results:All patients were treated by operation,there were only 56 patients(51.4%)were diagnosed at strangulating intestinal obstruction before operation the other 53 patients(48.6%).101 patientswere cured,8dead.The mortality was 7.3%.The main cause of death was septic shock?MOF?ARDS.Conclusion:Early diagnosis of strangulating intestinal obstruction was difficult.Intestine necrosis may be prevented by analysing carefully the clinical features and related examinations.Early operation was the key procedure of decreasing mortality.