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[小肠疾病的外科治疗]

[Surgical treatment of diseases of the small intestine].

作者信息

Lutsevich E V, Gribkov Iu I, Ignatév V G, Lutsevich O E, Urbanovich A S, Shamsiev B

出版信息

Khirurgiia (Mosk). 1993 Apr(4):30-6.

PMID:8084166
Abstract

The article deals with experience in surgical treatment of 375 patients with various diseases of the small intestine, rare diseases (tuberculosis, enterolithiasis, tumors, etc.) among others. These diseases were usually manifested clinically in the late stages by ileus, peritonitis or bleeding into the gastrointestinal tract. Most patients with surgical diseases of the small intestine were subjected to operation for emergency indications. Such instrumental methods as laparoscopy, selective endoscopic radiocontrast study of the small intestine, angiography, etc. are important in the diagnosis of the diseases. The authors emphasize the high diagnostic efficacy of a special method of selective endoscopic radiocontrast study, especially in tumors of the small intestine. According to the authors, general mortality rate in diseases of the small intestine is high (13%) and is mainly due to such diseases as disorders of mesenteric blood circulation, incarceration of the intestine in a hernia, adhesive obstruction, volvulus, etc. The authors claim that mortality in diseases of the small intestine can be reduced if early diagnosis, early hospitalization, and adequate surgical interventions are ensured. Among the factors contributing to increase of the efficacy of surgical operations the authors indicate efficacy of surgical operations the authors indicate precision techniques of intestinal suture application with atraumatic suture material, the use of complex biological protection of the anastomosis including treatment with low-frequency ultrasound and subsequent application of collagenic films in which antibacterial agents are deposited, and measures for stimulating reparative regeneration.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本文探讨了375例患有各种小肠疾病患者的外科治疗经验,其中包括罕见疾病(结核病、肠结石症、肿瘤等)。这些疾病通常在临床晚期表现为肠梗阻、腹膜炎或胃肠道出血。大多数患有小肠外科疾病的患者因急诊指征接受手术。腹腔镜检查、小肠选择性内镜放射性造影研究、血管造影等器械方法在疾病诊断中很重要。作者强调了一种特殊的选择性内镜放射性造影研究方法的高诊断效能,尤其是在小肠肿瘤方面。据作者称,小肠疾病的总体死亡率很高(13%),主要是由于肠系膜血液循环障碍、肠疝嵌顿、粘连性肠梗阻、肠扭转等疾病。作者声称,如果能确保早期诊断、早期住院和适当的外科干预,小肠疾病的死亡率可以降低。在有助于提高外科手术疗效的因素中,作者指出了手术操作的效能,即使用无创伤缝合材料的精确肠缝合技术、包括低频超声治疗及随后应用含有抗菌剂的胶原膜的吻合口复合生物保护措施,以及刺激修复性再生的措施。(摘要截选于250字)

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