Costa O L, Colombo C A, Oliveira J H, Motta M R, Yoshida O S, Faintuch J
Rev Hosp Clin Fac Med Sao Paulo. 1989 Jan-Feb;44(1):25-8.
The indications for colostomies in traumatic lesions of the colon were prospectively analysed in the light of the anatomical and functional impairment, the time that elapsed after the injury and additional risk factors. In the period between January 1981 and June 1986 75 patients were operated for colonic trauma: 39 had gunshot wounds, 29 suffered stab wounds and seven had blunt injuries. Colostomies were indicated in 47 patients that presented the most severe lesions, whereas the other 28 patients underwent primary repair. Infectious complications occurred in 21 cases; they were related to a pre-operative interval of more than 10 hours, severity of colonic lesion (CIS) grade III to V, blood transfusion of more than 2500 ml, the presence of colostomy, and an abdominal trauma index (PATI) of more than 25. Five patients died in consequence of infectious complications (p less than 0.05), all of them suffering from severe injuries. These findings suggest that in acute trauma of the colon after less than 6 hours colostomy is justified when the CIS is III to V, the PATI more than 25, or in hemodinamically unstable patients.
根据结肠创伤的解剖学和功能损伤、受伤后经过的时间以及其他风险因素，对结肠创伤性病变行结肠造口术的指征进行了前瞻性分析。1981年1月至1986年6月期间，75例患者因结肠创伤接受手术：39例为枪伤，29例为刺伤，7例为钝性损伤。47例出现最严重病变的患者行结肠造口术，而其他28例患者接受了一期修复。21例发生感染性并发症；它们与术前间隔超过10小时、结肠病变严重程度（CIS）III至V级、输血超过2500ml、存在结肠造口以及腹部创伤指数（PATI）超过25有关。5例患者因感染性并发症死亡（p<0.05），他们均遭受重伤。这些发现表明，在结肠急性创伤后6小时内，当CIS为III至V级、PATI超过25或血流动力学不稳定的患者时，结肠造口术是合理的。
