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[小儿粘连性肠梗阻的诊断与治疗]

[Diagnosis and treatment of adhesive intestinal obstruction in children].

作者信息

Isakov Iu F, Stepanov E A, Dronov A F, Shumov N D, Blinnikov O I, Archibong A

出版信息

Khirurgiia (Mosk). 1990 Aug(8):3-7.

PMID:2147969
Abstract

The work analyses 455 patients with acute adhesive intestinal obstruction (194 children with the early and 261 with the advanced stage of the disease). The most common causes of the obstruction were acute appendicitis, developmental anomalies of the intestine, and intestinal intussusception. Complete viscerolysis and horizontal intestinoplication by means of medical glue without application of sutures were performed in a total adhesion process, even in the acute period (34 cases). Severe paresis or paralysis of the gastrointestinal tract is an indication for its decompression. Laparoscopy was conducted in 90 children (from 3 months to 14 years of age) in suspected acute adhesive intestinal obstruction. The diagnosis was confirmed or defined more exactly in 64 patients. As the result of endoscopic operations intestinal obstruction was corrected and laparotomy was avoided in almost half of the patients. The total mortality was 1.3%.

摘要

该研究分析了455例急性粘连性肠梗阻患者(194例处于疾病早期的儿童患者和261例处于疾病晚期的患者)。肠梗阻最常见的病因是急性阑尾炎、肠道发育异常和肠套叠。在整个粘连过程中,即使在急性期,也采用医用胶水进行完全粘连松解和水平肠折叠术,无需缝合(34例)。严重的胃肠道麻痹或瘫痪是进行胃肠减压的指征。对90例疑似急性粘连性肠梗阻的儿童(年龄从3个月至14岁)进行了腹腔镜检查。64例患者的诊断得到了证实或更准确的明确。内镜手术的结果是,几乎一半的患者肠梗阻得到纠正,避免了剖腹手术。总死亡率为1.3%。

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