术前肠准备治疗尖锐肠不可通性肿瘤的疗效观察

H. S. Nazarov, S. Nazarov, N. Hasanov
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摘要

的目标。目的提高肿瘤源性急性肠梗阻根治术患者的手术治疗效果。材料和方法。本文对31例34 ~ 72岁的肿瘤源性急性结肠梗阻患者进行了观察和治疗。最常见的是直肠乙状结肠的肿瘤位置。研究组14例(45.2%),对照组17例(54.8%)。为了诊断目的,进行了一般临床和生化血液检查、超声、MRI、CT、结肠镜检查、直肠单腔镜检查和腹腔镜视频检查,并对切除的乳糜泻肿瘤宏观制备的活检标本进行了病理组织学检查。结果和讨论。结果发现,按照临床建议的方法进行术前准备的主组患者炎症过程和中毒指标明显下降;对照组术前准备按传统方案进行,术后早期实验室及仪器指标恢复正常。对照组2例(11.8%)患者出现缝合不一致,3例(17.6%)患者出现术后创面脓性。1例(5.9%)因心肌梗死死亡。主组患者仅1例(7.1%)出现术后创面炎症。结论。术前对肠袢上段进行减压联合肠吸收是根治性手术前肠道准备的有效方法,有助于减少术后早期脓性炎症并发症的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficiency of pre-operative preparation of intestines at treatment of sharp intestinal impassability tumoral genesis
   Aim. To improve the results of surgical treatment of patients with acute intestinal obstruction of tumor genesis during radical surgery.   Material and methods. Results of observation and treatment of 31 patients with acute colonic obstruction of tumorous genesis at the age from 34 till 72 years are presented. The most frequently observed was rectosigmoidal location of the tumor. The study group included 14 patients (45,2 %), in the control group - 17 (54,8 %). For diagnostic purposes general clinical and biochemical blood tests, ultrasound, MRI, CT, colonoscopy, rectoromonoscopy and video laparoscopy when indicated as well as pathohistological examination of biopsy specimens, taken from macro preparations of removed celiac tumor were carried out.   Results and discussion. It was found out that more expressed decrease of inflammatory processes and intoxication indexes is observed in the patients of the main group, which were preoperatively prepared according to the method suggested in the clinic; early normalization of the laboratory and instrumental indexes in the postoperative period in comparison with the control group of patients, in which preoperative preparation was performed according to the traditional schemes. In 2 (11,8 %) cases of the control group patients suture inconsistency was revealed, in 3 (17,6 %) cases - purulence of the postoperative wound. In 1 case (5.9 %) lethal outcome was registered due to myocardial infarction. Inflammation of the postoperative wound was observed only in 1 (7,1 %) case among the main group patients.   Conclusion. Decompression of the upper section of the bowel loop in combination to enterosorption in the preoperative period is the effective method of the bowel preparation for the radical surgery and promotes to decrease the frequency of the early postoperative purulent-inflammatory complications.
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