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原发性腹茧症的诊断及外科治疗:12例病例分析

郭俊超,  夏蜀臖,  张太平,  赵玉沛

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文章导航 > 协和医学杂志  > 2013 >  4(2): 165-168
郭俊超, 夏蜀臖, 张太平, 赵玉沛. 原发性腹茧症的诊断及外科治疗:12例病例分析[J]. 协和医学杂志, 2013, 4(2): 165-168. doi: 10.3969/j.issn.1674-9081.2013.02.017
引用本文: 郭俊超, 夏蜀臖, 张太平, 赵玉沛. 原发性腹茧症的诊断及外科治疗:12例病例分析[J]. 协和医学杂志, 2013, 4(2): 165-168. doi: 10.3969/j.issn.1674-9081.2013.02.017
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Jun-chao GUO, Shu-jun XIA, Tai-ping ZHANG, Yu-pei ZHAO. Diagnosis and Surgical Treatment of Primary Abdominal Cocoon:Report of 12 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2013, 4(2): 165-168. doi: 10.3969/j.issn.1674-9081.2013.02.017
Citation: Jun-chao GUO, Shu-jun XIA, Tai-ping ZHANG, Yu-pei ZHAO. Diagnosis and Surgical Treatment of Primary Abdominal Cocoon:Report of 12 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2013, 4(2): 165-168. doi: 10.3969/j.issn.1674-9081.2013.02.017
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原发性腹茧症的诊断及外科治疗:12例病例分析

doi: 10.3969/j.issn.1674-9081.2013.02.017

  • 中国医学科学院 北京协和医学院 北京协和医院基本外科, 北京 100730

详细信息
    通讯作者:

    赵玉沛 电话:010-69155805, E-mail:zhao8028@263.com

  • 中图分类号: R572.4

Diagnosis and Surgical Treatment of Primary Abdominal Cocoon:Report of 12 Cases

  • Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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    摘要
  • 摘要:   目的  分析原发性腹茧症的临床特点, 以提高对该病的认识, 选择合理的外科治疗手段。  方法  回顾性分析北京协和医院基本外科2002年1月至2012年1月收治的12例腹茧症患者的临床资料。  结果  本组患者中男8例, 女4例。主要临床表现为腹痛、腹胀、恶心、呕吐, 其次为腹部包块; 腹部超声是最常用的检查方法, 6例患者行CT检查, 其中1例考虑为腹茧症; 12例患者均接受手术治疗, 其中8例行小肠部分切除。术后排气时间平均(5.8±3.0) d, 术后进食时间平均(14.8±3.6) d, 术后平均住院时间(28.2±6.5) d。6例患者(50%)术后发生胃排空障碍, 4例出现腹腔感染, 2例发生吻合口瘘, 手术死亡3例(25%)。除3例死亡病例外, 其余9例患者均获得随访, 平均随访时间16个月, 其中6例恢复良好, 无再发肠梗阻; 3例仍存在不完全肠梗阻表现, 但可经保守治疗缓解。  结论  腹茧症术前诊断比较困难, 腹部超声是最常用的检查手段, 腹部增强CT有助于本病的诊断, 如有反复发作的肠梗阻表现, 宜行手术治疗。
    Abstract:   Objective  To summarize our experiences in the diagnosis and treatment of primary abdominal cocoon.  Methods  The clinical data of 12 patients with abdominal cocoon who were treated in the general surgery department of Peking Union Medical College Hospital from January 2002 to January 2012 were retrospectively analyzed.  Results  Of these 12 patients, there were 8 males and 4 females. The main clinical manifestations included abdominal pain, abdominal distention, nausea, vomiting, and abdominal mass. Ultrasonography was the most frequent diagnostic approach. Computed tomography (CT) was performed in 6 cases, among whom only one patient was considered to be with abdominal cocoon. All these 12 patients received surgical treatment and 8 of them underwent partial intestinal excisions. The postoperative exhaust time was (5.8±3.0) days; the time to foodtaking was (14.8±3.6) days; and the mean hospital stay was (28.2±6.5) days. The postoperative complications included delayed gastric emptying (n=6), abdominal infection (n=4), and anastomotic fistula (n=2). Three patients (25%) died after the surgery due to sever infection and the remaining patients were followed up for 16 months (mean). Six patients well recovered, whereas the remaining 3 patients had incomplete intestinal obstruction and were given conservative treatment.  Conclusion  The preoperative diagnosis of abdominal cocoon remains challenging. Abdominal ultrasonography is the most commonly applied examination, and enhanced CT may facilitate the diagnosis. Surgery should be performed for patients with recurrent acute or chronic intestinal obstruction.
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    • 参考文献(17)
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出版历程
  • 收稿日期:  2013-01-21
  • 刊出日期:  2013-04-30

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