急性肠梗阻和弥漫性腹膜炎手术策略选择的特点

O. S. Olefir
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引用次数: 0

摘要

总结。本研究的目的是评估和比较GKN患者在肠切除术后接受一期吻合或仅造口的早期术后结果,并确定两组患者术后并发症和死亡率的相关因素。材料和方法。该研究包括63例急性肠梗阻和腹膜炎患者,他们接受了小肠切除术后形成空肠造口术。研究了影响患者选择完成手术干预的因素。研究的结果。在相对平等的条件下,非血管性病因急性肠梗阻及腹膜炎患者在切除小肠后,应优先采用肠间吻合术Meidl空肠吻合术“卸载”,当发现血管性病理引起的梗阻时,优先选择侧行临时终末造口术,根据适应证分阶段干预。结论。非血管性病因小肠切除后,应根据Meidl优先选择肠间吻合或y型吻合。死亡的唯一危险因素是术后多器官衰竭。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FEATURES OF CHOICE OF OPERATIVE TACTICS FOR ACUTE I NTESTINAL OBSTRUCTION AND DIFFUSED PERITONITIS
Summary. The aim of the study was to evaluate and compare the early postoperative outcomes of patients with GKN who received either primary anastomosis or only stoma formation after bowel resection with the identification of factors associated with postoperative complications and mortality in both groups of patients. Materials and methods. The study included 63 patients with acute intestinal obstruction and peritonitis who underwent resection of the small intestine followed by the formation of a jejunostomy. The factors affecting the choice of the option of completing the surgical intervention were studied. Research results. Under relatively equal conditions, after resection of the small intestine in patients with acute intestinal obstruction and peritonitis other than vascular etiology, preference should be given to interintestinal anastomoses with a Meidl jejunostomy for the purpose of «unloading», when obstruction caused by vascular pathology is detected — the preference is on the side temporary terminal uenostomy with staged interventions according to indications. Conclusions. After resection of the small intestine in case of non-vascular etiology, preference should be given to interintestinal anastomosis or Y-shaped anastomosis according to Meidl. The only risk factor for mortality is postoperative multiple organ failure.
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