摘要
目的探讨胆石性肠梗阻的诊断及治疗。方法比较腹部平片、Ｂ超和ＣＴ的术前诊断率。随访术后患者以了解不同手术方法的得失。结果腹部平片术前诊断率仅为２０％，辅以Ｂ超及ＣＴ则上升为７３％。７例Ⅰ期手术及３例Ⅱ期手术患者无死亡，无胆管炎发作。４例未处理胆肠瘘患者中２例反复发作胆管炎。结论仅靠腹部平片易漏诊，辅以Ｂ超及ＣＴ则能提高术前诊断率。争取Ⅰ期手术切除胆囊、闭合胆肠瘘，如有困难，则动员患者６周～８周后Ⅱ期手术。
Objective To study the diagnosis and treatment of gallstone ileus. Methods A diagnostic accordance rate of abdominal plain radiographs,B ultrasonagraphy and CT sca ning were compared.The patients were follewed up for judging the effects of different technique used in operation for gallstone ileus. Results The diagnostic accordance rate of abdominal plain film examination was only 20% before operation.It was raised to 73% with the help of B ultrasonography and CT examination .No death and cholangitis were found in 7 patients who underwent on one-stage operation and 3 who underwent a two-stage operation.Two of four patients who underwent enterolithotomy only suffered from recurrent cholangitis. Conclusion The preo perative diagnostic rate of gallstone ileus will be raised with the help of B ultrasonography and CT examination because the abdominal plain film examination alone often leads to a misdiagnosis.The one-stage operation was recommended to remove the stones and cholecyst and to repair the fistula.The two-stage operation should be performed within 6～8 weeks in case of need.
出处
《铁道医学》
1997年第1期14-15,共2页
Railway Medical Journal
关键词
胆石
肠梗阻
诊断
治疗
gallstone
ileus
diagnosis
treatment
