胃次全切除、胃空肠吻合术后腹内疝发生因素及其预防的探讨
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刘细平

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Study on the factors involved in the occurrence of internal abdominal hernia after subtotal gastrectomy and gastrojejunostomy and their prevention
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    目的:探讨腹内疝的发生因素,以期预防及降低病死率。方法:回顾性分析34例腹内疝患者的临床资料。结果:34例均发生在Billroth-II式术后(Eiselsberg术后26例及Moynihan吻合术后8例)。发病时间为术后1个月内至21年,1年以内发病者28例(82.4%)。突发上腹部疼痛伴腰背放射痛是其主要表现。本组术前误诊率为82.3%。全组均经手术治疗,病死率为29.4%。结论:腹内疝是一种严重并发症。Billroth-II术后凡出现肠梗阻临床表现的患者均应考虑此病,早期手术是降低其病死率的关键。

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    Abstract:Objective:To study the factors involved in the development of internal abdominal hernia after subtotal gastrectomy and gastrojejunostomy(Billroth II gastrectomy), and the means for their prevention and for decrease of mortality rate.Methods:The clinical datas of 34 cases of internal abdominal hernia occurred after gastrectomy were analyzed retrospectively. Results:All of the 34 cases of internal abdominal hernia developed after Billroth-II operation(26 cases after Eiselsberg operation and 8 cases after Moynihan anastomosis). The time of onset was from 1 month to 21 years after operation, and in 28 cases was during the first year after operation(82.4%).The chief complaint was sudden epigastric pain with radiation of pain to the back. The preoperative misdiagnostic rate was 82.3%. All cases were treated by operation. The postoperative mortality rate was 29.4%.Conclusions:Internal abdominal hernia is a serious complication of Billroth-II operation. Patients who present with symptoms of intestinal obstruction after Billroth-II operation should be considered to have internal abdominal hernia.The only key to decrease mortality rate is operative treatment as soon as possible.

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刘细平,钟德玝,林辉.胃次全切除、胃空肠吻合术后腹内疝发生因素及其预防的探讨[J].中国普通外科杂志,2006,15(9):11-681.
DOI:10.7659/j. issn.1005-6947.2006.09.011

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  • 在线发布日期: 2006-09-25