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本文通过对23例结肠癌致急性结肠梗阻的外科治疗,认为结肠癌是导致结肠梗阻的主要病因,术前低压钡灌肠有助于确诊。治疗上应尽早手术,术前大剂量抗生素静脉给药优于传统的口服给药。术式选择上右半结肠癌行Ⅰ期切除吻合。左半结肠癌若病情危重,不能耐受长时间的手术,可行Ⅰ期造瘘、Ⅱ期切除吻合。若患者病情允许,则应行Ⅰ期切除肿瘤,至于是Ⅰ期吻合,还是行Hartamris术,应根据局部的病理变化来决定。并认为术中肠道灌洗对促进吻合口的愈合和防止术后切口及腹腔感染有积极作用。
This article through the surgical treatment of 23 cases of colonic cancer caused by acute colonic obstruction, that colon cancer is the main cause of colonic obstruction, preoperative low pressure barium enema help diagnose. Treatment should be performed as soon as possible, and preoperative intravenous administration of large doses of antibiotics is superior to traditional oral administration. The operation was performed with a primary resection and anastomosis of right colon cancer. Left colon cancer in critical condition, can not tolerate surgery for a long time, feasible stage I fistula, II resection and anastomosis. If the patient’s condition permits, the tumor should be resected by stage I. For a stage I anastomosis, or Hartamris surgery, it should be based on local pathological changes. It is believed that intraoperative intestinal lavage has a positive effect on promoting anastomotic healing and preventing postoperative incisions and abdominal infections.