القرار الجراحي في انسدادات الأمعاء التالية للجراحة البطنية
Abstract
شملت الدراسة 50 مريضاً دخلوا مشفى الأسد الجامعي في اللاذقية خلال الفترة الواقعة بين عامي 2004-2002 في قسم الجراحة بتشخيص مبدئي انسداد أمعاء (حاد أو تحت حاد) مع سوابق فتح بطن جراحي.
تميزت الدراسة بسيطرة الذكور بنسبة 70% خاصة في العقدين الخامس والسادس.
كما تضمنت دراسة الأعراض والعلامات السريرية حيث كان الألم البطني هو العرض المسيطر بنسبة 96%, وتحديد نمط وتصنيف وموقع الانسداد بالاعتماد على القصة المرضية والفحص السريري والاستقصاءات الشعاعية والفحوص المتممة:
أ ـ نمط الانسداد: آلي (ميكانيكي) 96%.
ب ـ تصنيف الانسداد: انسداد تام 78%.
ج ـ موقع الانسداد: انسداد علوي 70%.
تم توزيع المرضى إلى مجموعتين علاجيتين (جراحي ـ محافظ) وفقاً واعتماداً على معايير سريرية وشعاعية ومخبرية حيث كانت نسبة العلاج المحافظ 44%, ونسبة العلاج الجراحي 56%.
The research included 50 patients in AL-ASSAD academic hospital in Lattakia: (2002-2004).
The research was carried on patients whom were admitted to the department of surgery with initial diagnoses of intestinal obstruction (acuteـsub acute) with previous laparatomy.
The research was characterized by a high rate of male patients 70%, especially those in their 5th and the 6th decades.
The research comprised the following:
Studying clinical signs and symptoms in which the abdominal pain was the prevailing symptom 96%.
Depending on the history, clinical examination, radiography investigation and comlementary examination we recognized:
- Obstruction type: Mechanical obstruction 96%.
- Obstruction classification: Complete obstruction 78%.
- Obstruction location: Upper obstruction 70%.
Depending on clinical, radiography and serology criteria the patients were divided into two therapeutic groups (conservative ـ surgical) in which the conservative rate was 44%, and the surgical was 56%.
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