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Clinical analysis and strategy for unusual types of acute intestinal obstructions

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Author:
No author available
Journal Title:
WORLD CHINESE JOURNAL OF DIGESTOLOGY
Issue:
22
DOI:
10.3969/j.issn.1009-3079.2007.22.018
Key Word:
少见急性肠梗阻;病因学;病死率;治产疗;诊断

Abstract: 目的:了解少见急性肠梗阻的临床特征,为制订诊疗对策提供参考依据.方法:利用SPSSl2.0统计软件包,回顾性分析我院2002-01/2006-08少见急性肠梗阻(病因构成比<3.0%)发病情况及诊治情况,病例分成3组:儿童组(0岁-,组Ⅰ),青少年与成年组(14岁-,组Ⅱ)和老年组(60岁-,组Ⅲ).结果:在338例急性肠梗阻病例中,少见急性肠梗阻是122例(36.1%).在少见急性肠梗阻中:男94例(77.0%),女28例(23.0%),病因36种(急性肠梗阻总病因数是41种),组Ⅰ 31例患者,13种病因;组Ⅱ62例,26种病因;组Ⅲ29例,14种病因.组Ⅰ,Ⅱ,Ⅲ患者就诊时间分别为:2.3±1.5 h, 60.0±43.2 h和84.0±67.2 h,有显著性差异(P=0.000);组Ⅰ,Ⅱ,Ⅲ患者急性生理和慢性健康评分(APACHEⅡ)分别为:2.5±1.8分,5.5±3.6分和17.8±5.8分,有显著性差异(P=0.000),3组患者的总手术治疗率为65.6%,病死9例,病死率为8.0%,组Ⅰ,Ⅱ,Ⅲ患者治愈率分别为100.0%,95.0%和79.3%,差异有显著性(P=0.000).结论:少见急性肠梗阻诊断困难,易延误治疗时机而造成高病死率;病情(局部病变与全身状况)的准确判断和有效的治疗(手术治疗与非手术治疗)是少见急性肠梗阻诊治的关键.

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