急性缺血性结肠炎的外科治疗及预后
Surgical management and outcome in acute ischemic colitis.
作者信息
Beck David E, de Aguilar-Nascimento Jose Eduardo
出版信息
Ochsner J. 2011 Fall;11(3):282-5.
BACKGROUND
Ischemic colitis is the most common form of gastrointestinal ischemia. Patients usually present with abdominal discomfort and bloody diarrhea. Treatment is contingent on the severity of disease. Mucosal/nongangrenous ischemia requires only supportive measures and medical management, whereas transmural/gangrenous ischemia may require prompt surgical intervention. The purpose of this study was to review the surgical management of ischemic colitis in a tertiary referral center.
METHODS
Retrospective chart review of patients with ischemic colitis managed from 1995 to 2000 at the Ochsner Foundation Hospital.
RESULTS
Forty-eight patients were identified. Ten of these had disease significant enough to require surgery (21%) and are the basis of this review. Eight were women, and the mean age was 71.4 years (range 43-85 years). Distribution of the disease was the right colon in 4 cases, pancolitis in 3, sigmoid in 2, and the left colon in 1. Nine patients underwent bowel resection: primary anastomosis in 3 and creation of a stoma in the other 6 (5 ileostomies and 1 transverse colostomy). Follow-up ranged from 3 days to 13.8 years. One patient died perioperatively.
CONCLUSION
Surgical management produced good results.
背景
缺血性结肠炎是胃肠道缺血最常见的形式。患者通常表现为腹部不适和血性腹泻。治疗取决于疾病的严重程度。黏膜/非坏疽性缺血仅需支持性措施和药物治疗，而透壁/坏疽性缺血可能需要及时的手术干预。本研究的目的是回顾一家三级转诊中心缺血性结肠炎的手术治疗情况。
方法
对1995年至2000年在奥施纳基金会医院接受治疗的缺血性结肠炎患者进行回顾性病历审查。
结果
共确定48例患者。其中10例病情严重到需要手术（21%），是本综述的基础。8例为女性，平均年龄71.4岁（范围43 - 85岁）。病变分布为右半结肠4例，全结肠炎3例，乙状结肠2例，左半结肠1例。9例患者接受了肠切除术：3例行一期吻合术，另外6例行造口术（5例回肠造口术和1例横结肠造口术）。随访时间为3天至13.8年。1例患者围手术期死亡。
结论
手术治疗取得了良好效果。
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