哈里逊内科学第版PartSectionChapterAcuteIntestinalObstruction（中英文对照翻译版）.docVIP

Etiology and Classification 病因学和分类 In 75% of patients, acute intestinal obstruction results from adhesive bands or internal hernias secondary to previous abdominal surgery or from external hernias. 75%的急性肠梗阻病例是由腹部手术后并发的粘连带或内疝和腹外疝引起的。The incidence of acute intestinal obstruction requiring hospital admission within the first few postoperative weeks is 5–25%, and 10–50% of these patients will require surgical intervention. 术后的最初几周需要住院的急性肠梗阻的发病率为5–25%，10–50%的急性肠梗阻病人需要手术治疗。The incidence of postoperative intestinal obstruction may be lower following laparoscopic surgery than open procedures. 腹腔镜手术的术后肠梗阻发病率比剖腹术低。 However, the laparoscopic gastric bypass procedure may be associated with an unexpected high rate of intestinal obstruction, with a higher reoperative rate. 然而，腹腔镜胃旁路术的术后肠梗阻的高发生率会导致再次手术率要高一些。Other causes of intestinal obstruction not related to previous abdominal surgery include lesions intrinsic to the wall of the intestine, e.g., diverticulitis, carcinoma, and regional enteritis; and luminal obstruction, e.g., gallstone obstruction, intussusception. 与腹部手术史无关的其他小肠梗阻病因包括肠壁病变，如憩室炎，癌，和局限性肠炎；以及肠腔内梗阻，如胆石阻塞，肠套叠等。 Two other conditions that must be differentiated from acute intestinal obstruction include adynamic ileus and primary intestinal pseudo-obstruction. 其他两类必须从急性肠梗阻中区分出来的梗阻类型包括麻痹性肠梗阻和原发性假性肠梗阻。 Adynamic ileus is mediated via the hormonal component of the sympathoadrenal system and may occur after any peritoneal insult; its severity and duration will be dependent to some degree on the type of peritoneal injury. 麻痹性肠梗阻是由肾上腺交感神经系统的激素成分介导的，可发生于的任何腹膜损伤后；其严重程度和持续时间一定程度上取决于式腹膜损伤的类型。Hydrochloric acid, colonic contents, and pancreatic enzymes are among the most irritating to the peritoneum, whereas blood and urine are less so. 盐酸，结肠内容物和胰酶对腹膜刺激最大，而血和尿则要小一些。 Adynamic ileus occurs to some degree after any abdominal operation. 麻痹性肠梗阻某种程度上发生于任何腹部手术后。Retroperitoneal hematoma, particularly associated with vertebral fracture, may cause severe adynamic ileus, and the latter may occ