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回肠造口术的发生率及并发症

Frequency and Complications of Ileostomy.

作者信息

Mehboob Ayesha, Perveen Sughra, Iqbal Mazhar, Moula Bux Kulsoom, Waheed Abdul

机构信息

General Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK.

General Surgery, Jinnah Post Graduate Medical Centre, Karachi, PAK.

出版信息

Cureus. 2020 Oct 29;12(10):e11249. doi: 10.7759/cureus.11249.

Abstract

Introduction Ileostomies are life-saving procedures used for temporary fecal diversion in complicated cases of ileal perforation. However, an ileostomy is associated with several complications. The goal of this study was to determine the frequency and complications of ileostomy in the Jinnah Postgraduate Medical Centre, Karachi, Pakistan. Methodology We conducted a longitudinal observational study from July 2019 to July 2020. All patients older than age 12 receiving an ileostomy were included. Patient examinations were conducted on the first postoperative day and were assessed for hemorrhage and necrosis. Examinations were conducted on the seventh postoperative day to assess stoma retraction, stenosis, prolapse, and high-output fistula. Patients were monitored via follow-up in the outpatient clinic every 15 days to record any complications for three months until the reversal was performed. All data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp.). Result A total of 84 patients who received ileostomies were included in the study. Most patients were male (n=62; 73.8%), and 22 were female (26.19%). Of the 84 patients in our study, 34 (40.48%) had tuberculous intestine, 23 (27.38%) had typhoid ileal perforation, 23 (27.38%) were trauma patients, and four patients (4.7%) had gangrenous appendicular perforation. 23 patients (27.3%) were discharged with no complications, and 61 patients (72.69%) developed complications. The most common complication was skin excoriation (19.4%), followed by wound infection (13%), nonfunctioning stoma (11.9%), prolapse and stenosis (6%), retraction (4.7%), high-output fistula (3.5%), parastomal hernia and necrosis (2.3% each), and hemorrhage (1.1%). Conclusion Ileostomy is a common and lifesaving surgical diverting procedure. It is still common in our clinic due to late presentation by patients who need the procedure. Complications are common but manageable. Therefore, it is essential to recognize these complications and manage them early to reduce the morbidity of the patients.

摘要

引言

回肠造口术是用于复杂回肠穿孔病例临时粪便转流的挽救生命的手术。然而,回肠造口术会引发多种并发症。本研究的目的是确定巴基斯坦卡拉奇真纳研究生医学中心回肠造口术的发生率及并发症情况。

方法

我们于2019年7月至2020年7月进行了一项纵向观察性研究。纳入所有年龄大于12岁接受回肠造口术的患者。术后第一天对患者进行检查,评估有无出血和坏死情况。术后第七天进行检查,评估造口回缩、狭窄、脱垂及高流量瘘。每15天在门诊对患者进行随访监测,记录三个月内的任何并发症,直至进行回肠造口还纳术。所有数据采用IBM SPSS Statistics for Windows 25.0版软件(纽约州阿蒙克市:IBM公司)进行分析。

结果

本研究共纳入84例接受回肠造口术的患者。大多数患者为男性(n = 62;73.8%),22例为女性(26.19%)。在我们研究的84例患者中,34例(40.48%)患有结核性肠病,23例(27.38%)患有伤寒性回肠穿孔,23例(27.38%)为创伤患者,4例(4.7%)患有坏疽性阑尾穿孔。23例患者(27.3%)无并发症出院,61例患者(72.69%)出现并发症。最常见的并发症是皮肤擦伤(19.4%),其次是伤口感染(13%)、造口无功能(11.9%)、脱垂和狭窄(6%)、回缩(4.7%)、高流量瘘(3.5%)、造口旁疝和坏死(各2.3%)以及出血(1.1%)。

结论

回肠造口术是一种常见且挽救生命的外科转流手术。由于需要该手术的患者就诊较晚,在我们的诊所中仍然很常见。并发症很常见但可控制。因此,必须认识到这些并发症并尽早进行处理,以降低患者的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5930/7707129/6aa17aecb670/cureus-0012-00000011249-i01.jpg

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