28例肠套叠合并休克的救治体会

摘要

目的 探讨肠套叠合并休克患者的围手术期救治方案.方法 选取28例肠套叠合并休克患者,在充分液体复苏纠正休克的同时予气管内插管全麻下手术探查,术中果断处理可疑肠管,迅速解除梗阻,恢复微循环灌注,防控术中低体温.结果 28例均复苏成功,23例行回结肠切除术,4例肠楔型切除术,1例回肠双腔造瘘术,均治愈出院.结论 及时采取充分的液体复苏及针对性抢救措施,纠正休克,准确把握术中病变肠管的活力及处理,可成功治愈肠套叠合并休克的危重症患者.%Objective To explore the perioperative treatment of shock patients with intussusception.Methods For 28 shock cases with intussusception,full liquid resuscitation,endotracheal intubation under general anesthesia,decisive handling of suspected intestinal segments,rapid relief of obstruction,restoration of microcirculatory perfusion and prevention of intraoperative hypothermia were performed.Results All shock cases were successfully resuscitated.Then the procedures of ileocolonic resection (n =23),intestinal wedge resection (n =4) and double cavity stoma of ileum (n =1) were performed.Conclusions Timely resuscitation,targeted rescues,correcting shock and accurate gauge of intestinal vitality may successfully treat shock cases complicated with intussusception.