结肠憩室炎急性穿孔的外科处理（附四例分析）

目的　探讨结肠憩室炎穿孔的临床表现与处理。方法　收治结肠憩室炎急性穿孔患者4例 ,年龄 5 5～ 71岁。 4例手术治疗。对其临床资料及外科治疗进行回顾性分析。结果　死亡 1例 ,切口感染 1例 ,3例痊愈出院。结论　结肠憩室炎急性穿孔处理应根据患者全身状况和腹腔污染等情况综合判定。关键是切除病变 ,控制脓毒败血症休克 ,防治合并症 ,引流通畅。对 4 0岁以下结肠憩室炎及顽固性便秘的多发性憩室炎患者 ,预防性结肠大部切除可防止憩室穿孔的发生

Surgical treatment of acute perforation induced by colonic diverticulitis: Clinical analysis of 4 cases

Objective To explore the clinical manifestation and treatment of acute performation induced by colonic diferticulitis. Methods The clinical data and surgical treatment of 4 cases of acute perforation induced by the colonic diverticulitis, age 55 to 71 years, were retrospectively analyzed. Results All the patients were subjected to operation. Death occurred in one patients and infection of the incision in one. The remaining were cured and discharged from the hospital. Conclusions The management of acute perforation induced by the colonic diverticulitis should be judged according to the patient's systemic condition and contamination of the abdominal cavity. The key to the good management is excision of the diseased side, control for the shock caused by pyosepticemia, prevention and treatment of complications, drainage to make the intestines unobstructed, and proper operative moded. In the patients under the age of 40 with colonic diverticulitis and those with multiple diverticulitis of the colon complicated by intractable constipation, the preventive excision of most parts of the colon can prevent perforation of colonic diverticulum.