中国普通外科杂志2012，Vol.21Issue(10)：1260-1265,6.
放射性肠炎并发急性肠梗阻的临床特点及治疗
Clinical characteristics and management of radiation enteritis with acute intestinal obstruction
刘亮 1张楠 1邹常林 1杨士民 1周振理1
作者信息
- 1. 天津市南开医院胃肠外科,天津300100
- 折叠
摘要
Abstract
Objective: To analyze the clinical characteristics and treatment approaches of radiation enteritis with acute bowel obstruction. Methods: The clinical data of 25 patients with radiation enteritis complicated by acute bowel obstruction admitted from October 2006 to March 2011 were retrospectively analyzed. Results: All patients underwent conservative treatment such as catheter intestinal decompression and aggressive nutritional support, and once their emergency conditions were alleviated, selective gastrografin contrast examination of the small bowel was performed via the decompression catherer to reveal the pathologic changes causing obstruction. Of the entire group, 24 cases underwent surgical treatment. Intraoperative findings showed that most radiation injuries occurred in the pelvic cavity or ileum, and there were indistinct borders between intestinal loops as well as abdominal organs, which were even adhered together in a frozen- like state. Thirteen patients underwent resection of obstructing lesion with anastomosis, 10 patients underwent ileocolic bypass anastomosis, right hemicolectomy was performed in one patient; and small intestine intubation and plication techniques were synchronously used in 21 cases. The bowel obstruction was resolved in one patient with nonsurgical treatment. Except for one patient who died of intra-abdominal and lung infection after surgery, 24 of 25 patients (96.0%) were cured. Twenty-three patients were followed up for 6 to 24 months, and the long-term efficacy rate was 957% (22/23). Conclusion: Proper conservative treatment can change emergent operation to a scheduled or elective operation for radiation enteritis associated acute bowel obstruction. Resection of obstructing lesion with anastomosis or entero-enteric bypass anastomosis combined with small intestine intubation is the preferred procedure for surgical treatment of this condition.关键词
肠梗阻/外科学/辐射损伤/放射性肠炎Key words
Intestinal Obstruction/surg/ Radiation Injuries/ Radiation Enteritis分类
医药卫生引用本文复制引用
刘亮,张楠,邹常林,杨士民,周振理..放射性肠炎并发急性肠梗阻的临床特点及治疗[J].中国普通外科杂志,2012,21(10):1260-1265,6.
