严重放射性肠损伤28例的综合治疗

目的：探讨严重放射性肠损伤的综合治疗。方法：回顾28例严重放射性肠损伤患者的临床表现，诊断，治疗方法。肠粘连狭窄患者14例行回肠部分切除术，1例行右半结肠切除术，3例行乙状结肠直肠上端切除术。7例肠瘘患者有4例一期行肠瘘切除2，例行乙状结肠造瘘术。结果本组无死亡病例，1例发生低位结肠漏，4例因原发肿瘤复发死亡，所有患者肠功能，营养状态明显改善。结论：严重放射性肠损伤应积极进行手术治疗，配合临床营养支持可获得满意疗效。

Management of severe radiation injury of the bowels

ObjectivesTo evaluate the therapeutic result of various management for severe radiation injury of the bowels.MethodsThe clinical presentation, diagnostic approach, managements and therapeutic effects were analysed retrospectively in 28 severe radiation therapy caused enteric injury patients. In all intestinal stricture cases, partial ileal resection was performed in 14 patients, right hemicolectomy in 1 patient, rectosigmoid resection in 3 patients. Instestinal fistulae was treated by diseased segment resection and reanastomosis in 7 patients, sigmoidostomy was undertaken in 2 patients.ResultsThere was no inhospital mortality. One case suffered from low colonic fistula,4 died of recurrence of the primary tumor.Postoperative bowel function and nutrition status significantly improved in all patients.ConclusionSurgical management combined with nutrition support is safe and effective for the treatment of severe radiation caused enteric injury.