术后早期炎性肠梗阻的治疗

目的回顾术后早期炎性肠梗阻（early postoperative inflammatory ileus，EPII）的临床特点和诊疗经过，总结治疗经验及预防措施。方法对信阳市第一人民医院近10年来11例术后早期炎性肠梗阻患者的治疗经过进行回顾性分析。结果11例首次住院患者全部治愈出院，住院时间3周左右。其中1例患者16个月后因机械性肠梗阻再次手术，术后发生多器官功能障碍综合征而死亡。其余患者未再进行手术治疗，无复发者。结论①术后早期炎性肠梗阻不同于其他类型肠梗阻，为腹部手术后早期（2周左右）、因腹部手术或腹腔内炎症等原因导致的肠壁水肿和渗出而形成的一种机械性和动力性同时存在的肠梗阻。②合理的治疗源于正确的诊断，最棘手的问题是要与粘连性肠梗阻的区别。③EPII的非手术治疗是其主要治疗方法，安全、有效、并发症少；手术治疗，风险大、效果差、有严重的并发症。④EPII的预防在于对本病的认识。

Treatment of early postoperative inflammatory ileus

Objective To summarize treatment and preventive measures by review the clinical features and treatment of early postoperative inflammatory ileus. Methods Eleven cases of early postoperative inflammatory ileus patients in our hospital were reviewed retrospectively. Results All patients dis-charged from hospital, length of hospital stay were about three weeks. One patient had re - operanon 16 months later for mechanical intestinal obstruction, died of MODF. The other patients did not have surgery again,had no recurrence. Conclusions ① Early postoperative inflammatory small bowel obstruction （early postoperative inflammatory ileus,EPII） differs from the other types of bowel obstruction, is in the early stage after abdominal surgery （2 weeks）, because of abdominal surgery and intraperitoneal inflammation causes the intestinal wall edema and exudative form a mechanical and dynamic nature of intestinal obstruction. ② Reasonable treatment from the correct diagnosis, the most difficult problem is to differ from adhesion ileus. ③Non -surgical treatment of the EPII is safe, effective and has less complications; Surgery treatment has risks, poor effect, and serious complications. ④ The prevention of EPII is to understanding of the disease.