网膜补丁技术治疗伤寒性回肠穿孔。
Omental patch technique for the ileal perforation secondary to typhoid fever.
机构信息
Department of Surgery, J N Medical College, Aligarh, India.
出版信息
Saudi J Gastroenterol. 2011 May-Jun;17(3):208-11. doi: 10.4103/1319-3767.80386.
BACKGROUND/AIM: Enteric perforation is a grave complication of typhoid fever. Laparotomy with primary closure is the treatment of choice depending upon the bowel condition. Fecal fistula formation is the main concern in primary closure and the incidence of this complication dramatically decreases when omentum is used as a patch over primary closure.
MATERIALS AND METHODS
A total of 176 patients underwent laparotomy for enteric perforation and they were divided into two groups randomly; Group I--Primary closure with omental patch and Group II--Only primary closure. The outcomes were measured in relation to hospital stay, wound infection, septicemia, fecal fistula, and mortality.
RESULTS
The incidence of complications including fecal fistula and mortality is significantly lower in the group I patients. Fecal fistula occurs in 7.7% in group II, while in only 1.1% in group I. The mortality is also lower 3.3% in group II, while 1.1% in group I.
CONCLUSION
Primary closure with omental patch is a better option as compared with only primary closure in enteric perforation patients. It can be recommended as an alternative method to primary closure only in enteric perforation patients.
背景/目的：肠穿孔是伤寒的严重并发症。根据肠道状况，剖腹术和一期缝合是首选治疗方法。在一期缝合中，粪便瘘的形成是主要关注点，当使用大网膜作为一期缝合的补丁时，这种并发症的发生率显著降低。
材料和方法
共有 176 名患有肠穿孔的患者接受了剖腹术，他们被随机分为两组；组 I - 带网膜补丁的一期缝合，组 II - 仅一期缝合。测量了与住院时间、伤口感染、败血症、粪便瘘和死亡率相关的结果。
结果
组 I 患者的并发症发生率包括粪便瘘和死亡率明显较低。组 II 中粪便瘘的发生率为 7.7%，而组 I 中仅为 1.1%。组 II 的死亡率也较低，为 3.3%，而组 I 为 1.1%。
结论
与仅一期缝合相比，带网膜补丁的一期缝合在肠穿孔患者中是更好的选择。它可以作为肠穿孔患者仅行一期缝合的替代方法推荐。
Zotero 插件