自发性乙状结肠破裂一期修补术的诊疗分析：1例报告
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v7i2.13408
Abstract
本文报告一例65岁女性患者因自发性乙状结肠破裂行一期修补术的成功诊治经验。患者因下腹部疼痛1天入院,伴畏寒、发热及恶心呕吐。腹部CT提示消化道穿孔并腹膜炎,急诊腹腔镜探查发现乙状结肠与直肠交界处前壁破裂穿孔,直径约1.5cm。术中行一期修补术,术后恢复良好,未发生肠瘘、腹腔感染等并发症。术后病理提示肠黏膜炎症性坏死,术后3个月肠镜检查未见异常。本文结合文献探讨了自发性乙状结肠破裂的发病机制、诊断及手术方式选择,强调腹腔镜探查在精确定位诊断中的重要性,并指出在满足特定条件下,一期修补术是可行的治疗选择。
Keywords
自发性乙状结肠破裂；一期修补术；诊疗
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[3] SerpellJ W, Nicholls R J. Stercoral perforation of the colon[J].Journal of British Surgery,1990,77(12):1325-1329.
[4] 梁永杰,陈新华,梁延锐,等.多层螺旋CT腹腔游离气体五分法对急性消化道穿孔部位和大小的诊断价值[J].中华胃肠外科杂志,2024,27(3):268-273.
[5] LuP, Luo Y,Ying Z,et al.Prediction of injury localizat ion in preoperative patients with gastrointestinal perforati on:a multiomics model analysis[J]. BMC Gastroenterol, 2024,24(1):6.
[6] Pau,L,Navez,J,Cawich,SO, et al. Laparoscopic Management of Blunt and Penetrating Abdominal Trauma: A Single-Center Experience and Review of the Literature. Journal of Laparoe ndoscopic & Advanced Surgical Techniques vol.2021;31(11):1262-1268.
[7] 张琳鑫,毛根军,邵爱评.自发性结肠穿孔16例诊治体会[J].中华胃肠外科杂志,2006,9(3):249-249.
[8] 陶振洲,李洋,曹广,等.腹腔镜技术在普外科急腹症诊断及治疗中的应用价值研究[J].中国医药,2023,18(9):1347-1350.
[9] 娄运池,张学成,曾奕山,等.特发性乙状结肠破裂12例临床探讨[J].实用医学杂志,2001,17(4):319-320.
[10] StoneHH, Fabian TC. Management of perforating colon trauma:randomization between primary closure and exterioriz ation.Annals of Surgery,1979,190(4):430-436.
[11] Curran T J, Borzotta A P. Complications of primary repair of colon injury: literature review of 2,964 cases[J].The American Journal of Surgery,1999,177(1):42-47.
[12] 艾常华,王海鹏,陈伟,等.自发性乙状结肠破裂一期修补2例并文献复习[J].巴楚医学,2020,3(1):86-88.
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