成人肠套叠诊治探讨.docVIP

成人肠套叠诊治探讨 　　【摘要】 目的 探讨成人肠套叠的病因特点和诊治对策。方法 回顾性分析15例成人肠套叠的临床资料。结果 ①腹痛为最常见症状，共15例(100％)，有腹部肿块者8例(53.3％)，有血便者7例(46.7％)；②术前确诊为肠套叠者6例(40％)，肠梗阻13例(86.7％)，腹部包块疑消化道肿瘤5例(33.3％)，急性阑尾炎1例(6.7％)；③引起肠套叠的病变有：小肠肿瘤7例(46.7％)，小肠憩室2例(13.3％)，盲肠游离症1例(6.7％)，结肠肿瘤4例(26.7％)等；④本组均行剖腹手术治疗，术后无严重并发症，无死亡病例。结论 ①成人肠套叠大部分继发于小肠病变，且以小肠肿瘤最多见；②钡剂灌肠摄片、B超、纤维结肠镜有助于成人肠套叠的诊断，CT为最有诊断价值的检查；③治疗首选手术，腹腔镜也可以作为诊断与治疗的方法。 　　【关键词】 成人；肠套叠；诊断；治疗 　　 　　The investigation of diagnosis and treatment of adult intussusception 　　 　　YAO Yuan,LI Da-yong, LUO Chuan-yu. Department of General Surgery, The Second People?s Hospital of Wuh city in Anhui Province,Wuhu 241000,China 　　 　　【Abstract】 Objective To investigate the cause characteristics,diagnosis and clinical treatment of adult intussusception.Methods 15 cases with intussusception were retrospectively analyzed.Results ①Cases with abdominal pain in 15 cases(100％)，8 cases had a palpable abdominal mass(53.3％)，bloody stool in 7 cases(46.7％).②Correct diagnosis was made for intussusception preoperatively in 6 cases(40％).Other preoperative diagnosis included：intestinal obstruction in 13 cases，abdominal mass suspected as intestinal tumor in 5 cases(33.3％)，acute appendicitis in 1 cases. ③Causes of adult intussusceptions：small intestinal tumor in 7 cases(46.7％)，intestinal diverticulum in 2 cases(13.3％)，“cecum mobile”syndrome in 1 cases(6.7％)，tumor of large intestine in 4 cases，et al.④A1l underwent laparotomy，all cases recovered uneventfully after operation.There was no mortality.Conclusion ①Most of the adult intussusceptions were secondary to primary lesion，and most of them were small intestine tumors.②Ultrasonography，barium enema and colonoscopy are helpful in diagnosing adult intussusceptions， computed tomography(CT)proved to be the most useful diagnostic method.③Operative management is the first choice, laparoscopic surgery can be used as the method to diagnose and treat the adult intussusception. 　　【Key words】 Adult；Intussusception； Diagnsis；Operation 　　 　　一段肠管以及与其相连的肠系膜(套