摘要
目的成人急性小肠梗阻(small bowl obstruction,SBO)病因复杂,本研究旨在通过探讨SBO的病因谱特征及其与小肠绞窄的关系,为SBO的临床治疗提供科学依据。方法回顾分析2010年6月—2016年9月在南京医科大学鼓楼临床医学院住院手术的320例SBO的患者资料。按照是否合并小肠绞窄、绞窄程度、梗阻病因等不同分类方法,将患者分为不同病因组、绞窄组与单纯组、坏死亚组与可逆性绞窄亚组。分别统计各病因的分布情况、各病因与小肠绞窄的关系等。结果符合研究标准的320例成人SBO患者中,病因包括黏连107例(33.4%)、外疝73例(22.8%)、扭转46例(14.4%)、内疝32例(10.0%)、套叠28例(8.8%)、肿瘤7例(2.2%)、其他病因27例(8.4%)。其中,绞窄组的扭转与套叠例数显著多于单纯组(均P<0.05),绞窄组的肿瘤例数显著少于单纯组(P<0.05)。在绞窄组中,外疝与内疝引起的坏死亚组患者显著多于可逆性绞窄亚组患者(均P<0.05)。结论在成人SBO患者中,黏连仍是主要病因,其次是腹外疝;扭转与套叠倾向于引起小肠绞窄;外疝与内疝有引起不可逆性肠绞窄的倾向。
Objective Many causes can lead to small bowl obstruction （SBO）. The aim of this paper is to explore the characteristics of etiological spectrum of SBO and its relation with strangulated small bowel obstruction （SSBO） , and pro- vide scientific basis for the management of SBO. Methods The clinical data of 320 adult patients with SBO in our hos- pital between June, 2010 and September, 2016 were reviewed retrospectively. According to the degree of intestinal ische- mia and the pathogeny, the patients were divided into the simple group （non-strangulated group ） and the strangulation group （ including necrosis subgroup and non-necrosis subgroup）. The patbogeny distribution and its relationship to the in- testinal strangulation were analyzed. Results Of 320 cases, 107 （33.4%） had adhesions, 73 （22.8%） had external hernias, 46 （ 14.4% ） had volvulus, 32 （ 10.0% ） had internal hernias, 28 （8.8%） had intussusceptions, 7 （2.2%） had tumors, and 27 （8.4%） had other causes. The patients caused by volvulus and intussusceptions in the strangulated group were significantly more than that in the simple group（ P 〈 0.05 ）. The patients caused by tumor in the strangulated group were less than that in the non-strangulated group（ P 〈 0.05 ）. The number of patients with necrosis caused by exter- nal hernias and internal hernias were significantly more than that without necrosis （ P 〈 0.05 ）. Conclusion Adhesions is the principal cause of SBO in adults, following by external hernias. Volvulus and intussusceptions tend to cause SSBO in adults. External hernias and internal hernias easily lead to the small intestine necrosis.
作者
田晶
康星
汪灏
管文贤
何健
王军
TIAN Jing;KANG Xing;WANG Hao(Department of General Surgery, Gulou School of Clinical Medicine, Nanjing, Nanjing Medical University, Nanjing, Jiangsu 210008, China)
出处
《中华全科医学》
2018年第5期704-707,共4页
Chinese Journal of General Practice
基金
国家科技部项目(2016YFC0104105)
关键词
急性小肠梗阻
绞窄性肠梗阻
病因学
Acute small-bowel obstruction
Strangulation obstruction of the small bowel
Etiology
作者简介
通信作者：康星，E-mail：18912957297@163．com
