摘要
目的探讨胸腰段骨折、脱位前路手术后胃肠道并发症的原因及治疗。方法回顾性分析1999年1月-2004年10月经前路减压内固定治疗的胸腰段骨折、脱位患者153例。术后15例出现胃肠道并发症,其中动力性肠梗阻7例,应激性溃疡3例,肠道菌群失调3例,原发性结核播散导致结核性腹膜炎1例,慢性阑尾炎急性发作1例。结果15例患者通过查找原因和相应治疗,均得到有效控制。结论(1)胸腰段骨折、脱位前路手术后出现胃肠道并发症的主要原因是严重的原发创伤和(或)手术损伤胃肠道的植物神经、术中腹腔脏器挫伤,术后腹膜后血肿、急性胃黏膜病变、肠道菌群失调等；(2)注重原发创伤的处理、仔细手术、合理使用抗生素、及时对因治疗可有效控制胃肠道并发症。
Objective To explore the causes and treatment of gastrointestinal complications after anterior approach for thoracnlumbar fracture and dislocation. Methods A retrospective analysis was carried out in 153 cases with thoracolumbar fracture and dislocation undergone anterior approach from January 1999 to October 2003. Postoperative gastrointestinal complication was seen in 15 cases including seven with dynamic intestinal obstructions, three with stress ulcer, three with intestinal bacteria imbalance, one with tuberculosis peritonitis resulted from dissemination of primary tuberculosis, and one with acute relapse of chronic appendicitis. Results All patients were effectively cured by using corresponding methods in regard of different causes. Conclusions （ 1 ） Gastrointestinal complications following anterior approach for thoracolumbar fracture and dislocation are mainly resulted from following causes, ie, serious primary trauma, primary gastrointestinal vegetative nerve injury or that caused by surgical operation, intraoperative contusions of abdominal viscera, postoperative retroperitoneal hematoma, acute lesion of gastric mucous membrane as well as imbalance of intestinal flora. （2） Correct treatment of primary trau- ma, meticulous operation, reasonable utility of antibiotics and appropriate management can effectively prevent and control gastrointestinal complications.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2006年第6期408-410,共3页
Chinese Journal of Trauma
关键词
胸椎
腰椎
脊柱骨折
脱位
并发症
胃肠
Thoracic vertebrae
Lunbar vertebrae
Spinal fractures
Dislocations
Complications, gastrointestinal
