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我院于1991～1995年中,收治结肠肿瘤急性穿孔8例,均行一期肠切除吻合,避免近端造瘘需要二期手术痛苦,疗效满意。结合本组病例,作一回顾性分析。 临床资料 男性6例,女性2例。年龄最大68岁,最小26岁,50岁以上6例(75％)。出现症状到手术时间,最短4小时,最长28小时,合并休克2例。术中发现升结肠肿瘤穿孔2例,横结肠肿瘤穿孔1例,左结肠肿瘤穿孔5例。8例患者腹腔内都有粪液脓苔,最多2000ml,最少的600ml。手术方法:右半结肠切除2例,横结肠切除1例,左半结肠切除3例,左结肠病变肠段切除2例。8例均行一期肠切除吻合。关腹前在吻合处放置多孔引流管。病理报告:本组病例均为溃疡型腺癌。治疗结果:7例治愈,1例右半结肠切除并发肠外瘘。
In our hospital from 1991 to 1995, 8 patients with acute perforation of colon cancer were undergone primary bowel resection and anastomosis to avoid proximal endostomy requiring secondary surgical pain and satisfactory results. Combined with this group of patients, a retrospective analysis was performed. Clinical data were 6 males and 2 females. The oldest is 68 years old and the youngest is 26 years old. There are 6 cases (75%) over 50 years old. Symptoms to surgery time, the shortest 4 hours, the longest 28 hours, combined shock in 2 cases. Two cases of ascending colon tumor perforation, one case of transverse colon tumor perforation, and five cases of left colon tumor perforation were found. Eight patients had pus in the abdomen, with a maximum of 2000 ml and a minimum of 600 ml. Surgical methods: Right colon resection in 2 cases, transverse colon resection in 1 case, left colon resection in 3 cases, left colon resection in 2 cases. Eight patients underwent one-stage bowel resection and anastomosis. Place a porous drainage tube at the anastomosis before closing the abdomen. Pathology report: This group of patients were ulcerative adenocarcinoma. Treatment results: 7 patients were cured, and 1 patient had a bowel disease after resection of the right colon.