結腸自發性穿孔的診斷和治療_《華西醫學》

作者：

彭俊文 , 周長青

仁壽縣婦幼保健院外科（四川仁壽，620500）;

關鍵詞：

自發性腸穿孔結腸穿孔腹膜炎急腹癥

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【摘要】　目的　總結結腸自發性穿孔的病因、診斷和治療方法。　方法　回顧性分析2000年－2010年收治的9例因自發性結腸穿孔接受急診剖腹探查手術患者的臨床資料。　結果　平均發病年齡67.6歲（55～84歲），5例有慢性便秘病史；患者均以突發性腹痛起病，2例得到術前確診。1例行穿孔修補術，6例行穿孔修補或穿孔腸段切除加近端結腸造瘺術，2例行Hartmann手術。治愈出院6例，2例切口感染，1例嚴重感染。　結論　自發性結腸穿孔好發于老年長期便秘史者，通常預后不良，且術后病死率較高。早期發現和手術治療、徹底的腹腔內沖洗和嚴密的術后管理是改善預后的重要因素。

引用本文： 彭俊文,周長青. 結腸自發性穿孔的診斷和治療. 華西醫學, 2011, 26(7): 1076-1077. doi: 復制

1.	Maurer CA, Renzulli P, Mazzucchelli L, et al. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon [J]. Dis Colon Rectum, 2000, 43(7): 991-998.
2.	Haddad R, Bursle G, Piper B. Stercoral perforation of the sigmoid colon [J]. ANZ J Surg, 2005, 75(4): 244-246.
3.	Yano T, Wakabayashi H, Yachida S, et al. A stercoral perforation of the colon with an obvious faecal mass diagnosed by computed tomography [J]. ANZ J Surg, 2008, 78(3): 214-215.
4.	Yang B, Ni HK. Diagnosis and treatment of spontaneous colonic perforation: analysis of 10 cases [J]. World J Gastroenterol, 2008, 14(28): 4569-4572.
5.	Tokunaga Y, Hata K, Nishitai R, et al. Spontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature [J]. Surg Today, 1998, 28(9): 937-939.
6.	Serpell JW, Nicholls RJ. Stercoral perforation of the colon [J]. Br J Surg, 1990, 77(12): 1325-1329.
7.	Huang WS, Wang CS, Hsieh CC, et al. Management of patients with stercoral perforation of the sigmoid colon: report of five cases [J]. World J Gastroenterol, 2006, 12(3): 500-503.
8.	Durrans D, Redmond EJ, Marshman L. Stercoral perforation of the colon [J]. Br J Surg, 1991, 78(9): 1148.
9.	Patel VG, Kalakuntla V, Fortson JK, et al. Stercoral perforation of the sigmoid colon: report of a rare case and its possible association with nonsteroidal anti-inflammatory drugs [J]. Am Surg, 2002, 68(1): 62-64.
10.	Chen JH, Shen WC. Rectal carcinoma with stercoral ulcer perforation[J]. Hepatogastroenterology, 2000, 47(34): 1018-1019.
11.	馮延昌, 魏元明, 劉志民, 等. 實用臨床腹部外科少見病學[M]. 北京: 中國醫藥科技出版社, 2000: 206-207.

1. 　Maurer CA, Renzulli P, Mazzucchelli L, et al. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon [J]. Dis Colon Rectum, 2000, 43(7): 991-998.
2. 　Haddad R, Bursle G, Piper B. Stercoral perforation of the sigmoid colon [J]. ANZ J Surg, 2005, 75(4): 244-246.
3. 　Yano T, Wakabayashi H, Yachida S, et al. A stercoral perforation of the colon with an obvious faecal mass diagnosed by computed tomography [J]. ANZ J Surg, 2008, 78(3): 214-215.
4. 　Yang B, Ni HK. Diagnosis and treatment of spontaneous colonic perforation: analysis of 10 cases [J]. World J Gastroenterol, 2008, 14(28): 4569-4572.
5. 　Tokunaga Y, Hata K, Nishitai R, et al. Spontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature [J]. Surg Today, 1998, 28(9): 937-939.
6. 　Serpell JW, Nicholls RJ. Stercoral perforation of the colon [J]. Br J Surg, 1990, 77(12): 1325-1329.
7. 　Huang WS, Wang CS, Hsieh CC, et al. Management of patients with stercoral perforation of the sigmoid colon: report of five cases [J]. World J Gastroenterol, 2006, 12(3): 500-503.
8. 　Durrans D, Redmond EJ, Marshman L. Stercoral perforation of the colon [J]. Br J Surg, 1991, 78(9): 1148.
9. 　Patel VG, Kalakuntla V, Fortson JK, et al. Stercoral perforation of the sigmoid colon: report of a rare case and its possible association with nonsteroidal anti-inflammatory drugs [J]. Am Surg, 2002, 68(1): 62-64.
10. 　Chen JH, Shen WC. Rectal carcinoma with stercoral ulcer perforation[J]. Hepatogastroenterology, 2000, 47(34): 1018-1019.
11. 　馮延昌, 魏元明, 劉志民, 等. 實用臨床腹部外科少見病學[M]. 北京: 中國醫藥科技出版社, 2000: 206-207.

《華西醫學》

結腸自發性穿孔的診斷和治療

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《華西醫學》

結腸自發性穿孔的診斷和治療

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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