【摘要】 目的 總結(jié)結(jié)腸自發(fā)性穿孔的病因、診斷和治療方法。 方法 回顧性分析2000年－2010年收治的9例因自發(fā)性結(jié)腸穿孔接受急診剖腹探查手術(shù)患者的臨床資料。 結(jié)果 平均發(fā)病年齡67.6歲（55～84歲），5例有慢性便秘病史；患者均以突發(fā)性腹痛起病，2例得到術(shù)前確診。1例行穿孔修補(bǔ)術(shù)，6例行穿孔修補(bǔ)或穿孔腸段切除加近端結(jié)腸造瘺術(shù)，2例行Hartmann手術(shù)。治愈出院6例，2例切口感染，1例嚴(yán)重感染。 結(jié)論 自發(fā)性結(jié)腸穿孔好發(fā)于老年長期便秘史者，通常預(yù)后不良，且術(shù)后病死率較高。早期發(fā)現(xiàn)和手術(shù)治療、徹底的腹腔內(nèi)沖洗和嚴(yán)密的術(shù)后管理是改善預(yù)后的重要因素。
引用本文： 彭俊文,周長青. 結(jié)腸自發(fā)性穿孔的診斷和治療. 華西醫(yī)學(xué), 2011, 26(7): 1076-1077. doi: 復(fù)制
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- 1. Maurer CA, Renzulli P, Mazzucchelli L, et al. Use of accurate diagnostic criteria may increase incidence of stercoral perforation of the colon [J]. Dis Colon Rectum, 2000, 43(7): 991-998.
- 2. Haddad R, Bursle G, Piper B. Stercoral perforation of the sigmoid colon [J]. ANZ J Surg, 2005, 75(4): 244-246.
- 3. Yano T, Wakabayashi H, Yachida S, et al. A stercoral perforation of the colon with an obvious faecal mass diagnosed by computed tomography [J]. ANZ J Surg, 2008, 78(3): 214-215.
- 4. Yang B, Ni HK. Diagnosis and treatment of spontaneous colonic perforation: analysis of 10 cases [J]. World J Gastroenterol, 2008, 14(28): 4569-4572.
- 5. Tokunaga Y, Hata K, Nishitai R, et al. Spontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature [J]. Surg Today, 1998, 28(9): 937-939.
- 6. Serpell JW, Nicholls RJ. Stercoral perforation of the colon [J]. Br J Surg, 1990, 77(12): 1325-1329.
- 7. Huang WS, Wang CS, Hsieh CC, et al. Management of patients with stercoral perforation of the sigmoid colon: report of five cases [J]. World J Gastroenterol, 2006, 12(3): 500-503.
- 8. Durrans D, Redmond EJ, Marshman L. Stercoral perforation of the colon [J]. Br J Surg, 1991, 78(9): 1148.
- 9. Patel VG, Kalakuntla V, Fortson JK, et al. Stercoral perforation of the sigmoid colon: report of a rare case and its possible association with nonsteroidal anti-inflammatory drugs [J]. Am Surg, 2002, 68(1): 62-64.
- 10. Chen JH, Shen WC. Rectal carcinoma with stercoral ulcer perforation[J]. Hepatogastroenterology, 2000, 47(34): 1018-1019.
- 11. 馮延昌, 魏元明, 劉志民, 等. 實(shí)用臨床腹部外科少見病學(xué)[M]. 北京: 中國醫(yī)藥科技出版社, 2000: 206-207.