以麻痹性肠梗阻为主要临床表现的急腹症29例诊治分析

目的 总结以麻痹性肠梗阻为主要临床表现的急腹症的诊治经验。方法 回顾性分析哈尔滨医科大学第一临床医学院2005年1月至2008年5月收治的29例以麻痹性肠梗阻为主要临床表现的急腹症病人的临床资料。结果 29例包括：阑尾炎坏疽穿孔12例，胆囊穿孔3例，肝脓肿破溃2例，胃十二指肠穿孔5例，肠伤寒穿孔2例，蛔虫性小肠穿孔1例，结肠肿瘤致穿孔2例，急性血运障碍性肠梗阻2例。治愈27例（93.1%），死亡2例(6.9%)。结论 以麻痹性肠梗阻为主要临床表现的急腹症术前病因诊断困难，除外反射性、代谢性、药物性等因素应尽早剖腹探查。

Diagnosis and treatment of acute abdomen with main clinical features of paralytic ileus: a report of 29 cases

Diagnosis and treatment of acute abdomen with main clinical features of paralytic ileus: a report of 29 cases 　YUAN Chen-xi,SUN Bei,JIANG Hong-chi,et al. Department of General Surgery, the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China. Corrsponding author：SUN Bei, E-mail：sunbei70@tom.com Abstract Objective To summarize the experience of the diagnosis and treatment of acute abdomen with main clinical features of paralytic ileus. Methods Clinical data of 29 cases of acute abdomen with main clinical features of paralytic ileus admitted in the First Clinical College of Harbin Medical University from January 2005 to May 2008 were analyzed retrospectively. Results 29 cases included:12 cases of gangrenous appendicitis perforation,3 cases of perforation of gallbladder,2 cases of liver abscess, 5 cases of gastric and duodenum perforation,2 cases of jejunotyphoid perforation,1 case of ascariasis,2 cases of perforation of colon and 2 cases of acute ileus of blood supplying disorder. 27 cases were cured（93.1%）and 2 cases died (6.9%). Conclusion It is difficult to confirm the etiological diagnosis of acute abdomen with main clinical features of paralytic ileus before surgery. Exploratory laparotomy should be required as soon as possible except for the factors of reflex, metabolism and medicine.