结直肠损伤的特点和处理

目的 探讨结直肠损伤的特点和结肠损伤Ⅰ期修复的适应证以及直肠损伤和医源性结直肠损伤处理的特殊性。方法 总结分析1989年1月～2000年12月收治的结直肠损伤41例临床资料。结果 38例行急诊手术,术中出现并发症11例,占26.8％,2例术中损伤未发现以致形成直肠阴道瘘和腹膜后脓肿,1例结肠镜下息肉切除造成小穿孔在镜下用钛夹修补治愈。本组治愈39例,死亡2例,均死于严重的并发症。结论 了解结直肠损伤的特点,提高结直肠损伤的认识,掌握好结肠Ⅰ期修复手术的适应证、直肠损伤及医源性损伤处理的特殊性是减少结直肠损伤并发症,提高外科治疗效果的关键。

Characteristics and management of colorectal trauma

Objective To investigate the characteristics of colorectal trauma, the indications for one-stage repair, management of rectal and iatrogenic colorectal trauma. Methods From January 1989 to December 2000, clinical data of 41 patients with colorectal trauma were collected and analyzed. Results Emergency operations were performed on 38 patients, and complications occurred in 11 patients (26. 8% ) . Among the patients with iatrogenic trauma, rectovaginal fistula and retroperitoneal abscess arose because of operative trauma, small perforation in one patient due to polypectomy and was repaired with titanium clip. 39 patients were cured successfully, 2 died of the severe complications. Conclusion It is important to understand the characteristics of colorectal trauma, grasp indications for one-stage operation, and specificity of management of rectal trauma and iatrogenic colorectal trauma for decreasing the complication and improving the effect of surgical treatment.