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目的:总结基层医院结直肠癌性肠梗阻的诊断和治疗经验,探讨漏诊,误诊原因及目前存在的主要问题。方法:回顾性分析33例急性癌性结直肠梗阻的临床资料。结果:33例患者中术前基本明确诊断者26例,占78.8(26/33),经术中明确诊断者7例;行I期癌肿切除肠吻合或行Hartmann术21例,20例病愈出院,死亡1例;单纯造口4例,死亡1例,自动出院1例。结论急性癌性结直肠病人农村较城市发病率高,应尽快提高基层医院诊治水平,诊断应结合现病史、既往史,行I期癌肿切除肠吻合或Hartmann术,如行积极有效治疗,疗效满意。
OBJECTIVE: To summarize the experience of diagnosis and treatment of colorectal intestinal obstruction in primary hospitals, and to explore the causes of missed diagnosis and misdiagnosis, as well as the main existing problems. Methods: The clinical data of 33 patients with acute colorectal obstruction were retrospectively analyzed. Results: Of the 33 patients, 26 cases were diagnosed with definite basic preoperative diagnosis, accounting for 78.8% (26/33), 7 cases were diagnosed by operation, 21 cases were treated by resection of intestinal anastomosis or Hartmann operation, The more patients were discharged and died in 1 case; the simple stoma were 4 cases, 1 died and 1 case was discharged automatically. Conclusions The incidence rate of acute colorectal cancer patients in rural areas is higher than that in urban areas. The level of diagnosis and treatment of primary hospital should be improved as soon as possible. Diagnosis should be combined with the current history, past history, I-stage resection of intestinal anastomosis or Hartmann’s surgery, such as active and effective treatment satisfaction.