中国普通外科杂志

• 临床研究 • 上一篇    下一篇

急性胃扩张的诊治:附19例报告

周建平, 董明, 孔凡民, 李昱骥, 田雨霖   

  1. (中国医科大学附属第一医院 普通外科, 辽宁 沈阳110001)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2008-04-25
  • 通讯作者: 周建平

Diagnosis and treatment of acute gastric dilatation:a report of 19 cases

ZHOU Jianping, DONG Ming, KONG Fanmin, LI Yuji, TIAN Yulin   

  1. (Department of General Surgery, the First Affiliated Hospital, China Medical University, Shenyang 110001, China)
  • Received:1900-01-01 Revised:1900-01-01 Online:2008-04-25

摘要: 目的:探讨急性胃扩张的诊断和治疗
方法:回顾性分析35年间因急性胃扩张住院治疗的19例患者的临床资料,总结该病典型临床表现及治疗对策。
结果:19例中11例(57.9%)误诊。手术治疗15例,包括胃切开减压、胃造口术(6例),胃切开减压后再缝合创口(3例),胃切开减压、胃造口、空肠造口术(1例),胃底部分切除术(2例),十二指肠空肠吻合术(1例),空肠造口术(1例),开腹探查术未切开胃壁(1例),死亡4例(26.7%)。非手术治疗4例,主要措施为持续胃肠减压和液体复苏,死亡1例(25.0%)。
结论:急性胃扩张少见,临床表现不典型,误诊率高。如果行胃肠减压不见好转或有明确的腹膜炎体征应积极手术治疗。

Abstract: Abstract:Objective:To study the diagnosis and treatment of acute gastric dilatation.
Methods :The clinical data of 19 cases of acute gastric dilatation treated in the past 35 years in our hospital were retrospectively analyzed.
Results:Of 19 patients, 11 were misdiagnosed. Fifteen patients underwent operation, including gastrostomy (6 cases), gastrotomy (4 cases), partial gastric fundus resection (2 cases), others operations (2 case), and laparotomy exploration (1 case); among them four patient died. Four patients received conservative treatment and one of them died. The conservative therapy for acute gastric dilatation consisted of nasogastric decompression and fluid resuscitation.
Conclusions:Acute gastric dilatation is rare, rapidly progressive and fatal acute abdomeninal condition with atypical clinical manifestations and high misdiagnosis rate. If conservative therapy fails or typical signs of peritonitis are present, aggressive surgical intervention would be the best choice.

中图分类号: 

  • R 656.6
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