穿透性结肠损伤的处理
Management of penetrating colon injuries.
作者信息
Bostick P J, Heard J S, Islas J T, Johnson D A, Sims E H, Fleming A W, Sterling-Scott R P
机构信息
Department of Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, California.
出版信息
J Natl Med Assoc. 1994 May;86(5):378-82.
The management of colon injuries remains an area of major controversy. Selecting the patients who can undergo primary repair safely remains undefined. To address this issue, 231 consecutive patients with penetrating colon injuries were reviewed to determine those factors that affected outcome. Overall, there were 54 (25.2%) septic complications, with 36 (16.8%) wound infections and 18 (8.4%) intra-abdominal abscesses. There were seven (3.3%) deaths in the entire series. The surgical management method of the colon injury was not significant in wound infections (P > .39), intra-abdominal abscesses (P > .24), or mortality (P > .39). A more aggressive approach of primary repair should be performed for civilian colon injuries.
结肠损伤的处理仍然是一个存在重大争议的领域。选择能够安全接受一期修复的患者仍不明确。为解决这一问题，对231例连续性穿透性结肠损伤患者进行了回顾，以确定那些影响预后的因素。总体而言，有54例（25.2%）发生感染性并发症，其中36例（16.8%）为伤口感染，18例（8.4%）为腹腔内脓肿。整个系列中有7例（3.3%）死亡。结肠损伤的手术处理方法在伤口感染（P>.39）、腹腔内脓肿（P>.24）或死亡率（P>.39）方面并无显著差异。对于平民结肠损伤应采取更积极的一期修复方法。
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