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Received:February 17, 2022 Published Online:January 20, 2023
Received:February 17, 2022 Published Online:January 20, 2023
中文摘要: 目的探讨枣核致肠穿孔的临床特点与治疗方法，并分析加速康复外科（ERAS）围术期措施在枣核致肠穿孔老年患者中的应用效果。
方法回顾性分析2019年1月至2022年1月南京中医药大学附属医院普通外科收治的枣核致肠穿孔并应用ERAS理念治疗的5例患者的临床资料。
结果5例患者均行手术治疗，术中发现单发穿孔2例（其中空肠穿孔1例，乙状结肠穿孔1例），多发穿孔3例（其中回肠合并乙状结肠穿孔1例，回肠多发穿孔1例，空肠多发穿孔1例）。腹腔镜联合内镜手术1例，腹腔镜探查后开腹手术4例。5例均顺利康复出院，未出现手术相关并发症，术后住院时间为（7.80±2.14）d。
结论枣核致肠穿孔多发于高龄人群，好发于末段回肠和乙状结肠，手术中需注意多发穿孔可能，ERAS理念应用于急诊老年消化道穿孔手术是安全、可行的。
Abstract:ObjectiveToinvestigatetheclinicalcharacteristicsandtreatmentofintestinalperforationcausedbyjujubepits,andanalyzetheeffectofenhancedrecoveryaftersurgery（ERAS）perioperativemeasuresinelderlypatientswithintestinalperforationcausedbyjujubepits.
MethodsRetrospectiveanalysiswasperformedontheclinicaldataof5casesofintestinalperforationcausedbyjujubepitstreatedintheGeneralSurgeryDepartmentoftheAffiliatedHospitalofNanjingUniversityofChineseMedicinefromJanuary2019toJanuary2022andtreatedwithERASconcept.
ResultsAll5casesunderwentsurgicaltreatment,including2casesofsingleperforation（1caseofjejunumperforation,1caseofsigmoidcolonperforation）,3casesofmultipleperforation（1caseofileumcombinedwithsigmoidcolonperforation,1caseofileummultipleperforationand1caseofjejunummultipleperforation）.Laparoscopycombinedwithendoscopyin1case,laparotomyafterlaparoscopicexplorationin4cases.All5casesrecoveredsuccessfullyandweredischargedwithoutoperation-relatedcomplications.Thepostoperativehospitalstaywas（7.80±2.14）days.
ConclusionInintestinalperforationcausedbyjujubepits,theelderlyareinmajority,andtheperforationiscommonlysitedindistalileumandsigmoidcolon.Multipleperforationshouldbeexaminedduringoperation.ItissafeandfeasibletoapplyERASprotocolsingeriatricgastrointestinalperforationcases.
文章编号： 中图分类号：R656 文献标志码：B
基金项目:江苏省中医药局重点项目（ZD201903）
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