结肠癌性梗阻的诊断与治疗

作者重点讨论了结肠癌性梗阻的诊断和鉴别诊断。３ｏ例临床分析表明，梗阻的发生主要取决于癌肿的生物学行为及其部位，浸润性生长及左侧结肠癌容易引起梗阻。结肠癌性梗阻中３０％属于ＤｕｋｅｓＡ期和Ｂ期；临床误诊率高达７３．３％，其中主要误诊为粘连性肠梗阻和急慢性胃肠炎；Ｘ线钡剂灌肠的诊断符合率达９５．２％。左侧结肠癌性梗阻急诊一期切除吻合是可行的，少数病情严重者应施行改良Ｈａｒｔｍａｎｎ＇ｓ术。

THE DIAGNOSIS AND TREATMENT OF OBSTRUCTION OF THE COLON DUE TO CARCINOMA

The early diagnosis and differential diagnosis of the obstruction of the colon due to carcinomawere emphasized.By analysing the information of thirty consecutive patients,we discoveredwhether the tumor can result in ileus principally depends on its biological behavior and position.The tumors with infiItrative growth and located iii the left colon tend to cause obstruction, 30%of thetse cases were pathologically considered as stage A and stage B of Dukes classification.73.3% were delayed to be diagnosed,predominantly misdiagnosed as adhesive ileus and acute orchronic gastro-enteritis.Positive rate of barium enema examination was 95.2%.Primary resec-tion and anastomosis is practicable for the treatment of obstruction due to left colon carcinoma. Insome severe cases Hartmann's procedure can be performed.