Datsenko B M, Pulatov A K, Druzhinin E B
Khirurgiia (Mosk). 1994 Oct(10):41-4.
Obstruction of the large intestine of tumorous origin was treated by the traditional methods in 191 patients: an emergency operation in peritonitis or nonoperative management of the obstruction by cleansing enema, purgatives, and infusion-transfusion therapy. In another group of 341 patients emergency colonoscopy and ultrasonic diagnosis were resorted to and the "obstruction index" (Deltz et al. 1989) was used for objectification of the indications for an emergency operation. The method of fractional oral treatment with 30% solution of polyethelyne oxide-400 and 1% chloramphenicol was applied in this group. Traditional treatment caused resolution of the obstruction in 22.8% of patients in the control and in 28.3% of patients in the experimental group. Postoperative mortality was 24.1% and 16.4%, respectively. The obstruction index allowed correct evaluation of the indications for operation in 97% of cases, the number of forced operation reduced from 52.2% to 14.1%.
191例肿瘤源性大肠梗阻患者采用传统方法治疗:在腹膜炎时进行急诊手术,或通过清洁灌肠、泻药及输液输血疗法对梗阻进行非手术治疗。另一组341例患者采用急诊结肠镜检查和超声诊断,并使用“梗阻指数”(德尔茨等人,1989年)来客观确定急诊手术的指征。该组采用30%聚环氧乙烷-400溶液和1%氯霉素进行分次口服治疗的方法。传统治疗使对照组22.8%的患者和试验组28.3%的患者梗阻解除。术后死亡率分别为24.1%和16.4%。梗阻指数在97%的病例中能够正确评估手术指征,急诊手术数量从52.2%降至14.1%。