左半结肠及直肠损伤的处理

目的：探讨左半结肠及直肠损伤的手术方法。方法：对10年来收治的左半结肠及直肠损伤的33例病人作回顾性研究，根据Flint三级法和shannon五级法的标准，采取不同的手术方法，一期手术25例，其中单纯修补19例，切除吻合3例，一期修补加近端管状造瘘3例；二期手术8例，其中外置修补2例，造口术6例。结果：一期手术25例，无并发症和死亡，平均住院15d，二期手术8例，发生盆腔脓肿3例，经保守治愈2例，死于感染性休克1例。平均住院31．5d。结论：采取现代外科的一些手段，对左半结肠及直肠损伤的病人，如果病例选择合理，可放宽一期手术适应证。

ANALYSIS OF TREATMENT FOR 33 PATIENTS WITH TRAUMA OF LEFT COLON AND RECTUM

Objective:To explore the surgical methods of trauma of left colon and rectum Methods:33 patients with trauma of left colon and rectum were studied retrospectively The study lasted for 10 years According to Flint's and Shannon's classification,we made the choice of intervention The first phase operation was performed on 25 patients,including primary repair(19 cases), resection and anostomosis(3 cases) And 3 cases had simple repair and colostomy with a mushroom tube in proximity of injury site The second phase operation was performed on 8 patients Colostomy was performed on 6 patients,and exteriorized repair of colon injures(ERCI) on 2 patients Results:There was no complications in primary operation The average hospitalizing time was 15 days 3 of 8 patients after colostomy suffered from pelvic abscess The average hospitalizing time was 31 5 days Conclusion: If patients were selected carefully and proper operation was performed,it is possible to broaden the indication of phase operation