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目的探讨急性绞窄性肠梗阻的外科治疗方法。方法回顾性分析我院2007年1月至2009年11月间收治的急性肠梗阻患者68例的治疗过程,分析与死亡相关的风险因素。结果所有病例均手术治疗,治愈59例,死亡13例,死亡率为19.12%;5～10岁病例的死亡率13.04%(6/46);60岁以上者13例,死亡5例,死亡率为38.46%,与总死亡率和5～10岁组相比有统计学意义;术前确诊为绞窄性肠梗阻共46例,死亡4例,死亡率8.7%;术前未确诊的22例因其他原因行剖腹探查时确诊,术后死亡9例(死亡率40.91%)。两组死亡率差别具有统计学意义。结论绞窄性肠梗阻的主要死亡原因依次为MOF、急性肾功能衰竭、感染性休克、ARDS和严重水、电解质紊乱。老年人和儿童的死亡率较高,早期诊断和及时手术是降低绞窄性肠梗阻死亡率的关键。
Objective To investigate the surgical treatment of acute strangulated intestinal obstruction. Methods A retrospective analysis of 68 patients with acute intestinal obstruction admitted to our hospital from January 2007 to November 2009 was conducted to analyze the risk factors associated with death. Results All the cases were surgically treated, 59 cases were cured, 13 cases died, the death rate was 19.12%; the mortality rate was 13.04% (6/46) in 5 ~ 10 years old; 13 cases were over 60 years old; 5 cases died; 38.46%, with the total mortality and 5 to 10 years old group was statistically significant; preoperative diagnosis of strangulated intestinal obstruction in 46 cases, 4 patients died, the mortality rate was 8.7%; preoperative undiagnosed 22 cases For other reasons, laparotomy was diagnosed during the postoperative death in 9 cases (mortality 40.91%). The difference in mortality between the two groups was statistically significant. Conclusion The main causes of strangulated intestinal obstruction were MOF, acute renal failure, septic shock, ARDS and severe water and electrolyte imbalance. Older persons and children have a higher mortality rate. Early diagnosis and prompt surgery are the keys to reducing the mortality of strangulated intestinal obstruction.