تقييم طرق تدبير رضوح القولونات والأمعاء الدقيقة حربية المنشأ بين عامي 2012-2017
Abstract
The research aims to evaluate the management of war related colon and small intestines trauma between 2012-2017years at Alasad and Tishreen Hospitals in Latakia from the beginning of March 2012 until the beginning of September 2017.
82 Patients (52 Males, 30 Females). 26 patients had small intestinal injuries and 38 Patients had colonic injuries, whereas 18 Patients had both small and large bowel injuries.
With small bowel injuries: 16 patients (61.6%) were treated with primary suture and eight patients (30.7%) were treated with resection and anastomosis, whereas two patients (7.7%) were treated by ileostomy.
With colonic injuries: 24 Patients (42.8%) were treated with primary suture and 3 Patients (5.3%) were treated with resection and anastomosis without colostomy , and 7 Patients (12.5%) were treated with resection and anastomosis without colostomy , and 9 Patients (16.2%) were treated with Hartman procedure , whereas 13 Patients (23.2%) were treated with colostomy.
أجريت هذه الدراسة بهدف تقييم طرق تدبير رضوح القولونات والأمعاء الدقيقة حربية المنشأ في مشفيي جامعة تشرين الجامعية ومقارنتها مع الطرق المتبعة عالميا.
شملت الدراسة المرضى المقبولين في قسم الجراحة بتشخيص رضوح القولونات والأمعاء الدقيقة الحربية النافذة في هذين المشفيين الجامعيين خلال الفترة الممتدة بين 1/3/2012 و 1/9/2017.
شملت عينة الدراسة 82 مريض (52 ذكراً و30 أنثى)، كانت الأمعاء الدقيقة مصابة عند 26 مريضاً والقولونات عند 38 مريضاً مع وجود أذيات مشتركة بين الأمعاء الدقيقة والقولونات عند 18 مريضاً.
عند إصلاح أذيات الأمعاء الدقيقة تم إجراء الخياطة المباشرة عند 16 مريضاً (61.6%) والبتر والمفاغرة عند 8 مرضى (30.7%) بينما أجري فغر اللفائفي عند مريضين فقط (7.7%).
أما عند إصلاح أذيات القولونات فتم إجراء الخياطة المباشرة عند 24 مريضاً (42.8%) وإجراء البتر والمفاغرة دون فغر عند 3 مرضى (5.3%) والبتر والمفاغرة مع فغر عند 7 مرضى (12.5%) وتم إجراء عملية هارتمان(التي تشمل استئصال القسم المتأذي من الأمعاء وإخراج النهاية القريبة للعروة المعوية على شكل شرج مضاد للطبيعة وإغلاق النهاية البعيدة وإعادتها لجوف البطن) عند 9 مرضى (16.2%) بينما أجري فغر القولون عند 13 مريض (23.2%).
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