经鼻型肠梗阻导管联合生长抑素治疗腹部术后早期炎性肠梗阻的临床观察

目的:探讨经鼻型肠梗阻导管联合生长抑素对腹部术后早期炎性肠梗阻疗效。方法:对重庆市南川区人民医院2003年9月至2011年11月收治的43例腹部术后早期炎性肠梗阻患者,分别经鼻型肠梗阻导管减压联合生长抑素组(治疗组)、生长抑素联合鼻胃管胃肠减压组(生长抑素对照组)、鼻胃管胃肠减压组(胃管对照组)保守治疗。对三组的临床疗效进行比较。结果:治疗组15例全部经保守治疗治愈,治疗组腹痛缓解时间明显短于胃管对照组和生长抑素对照组,三组两两比较差异有统计学意义(P<0.05)。治疗组和生长抑素对照组恢复排气时间明显短于胃管对照组(P<0.05),治疗组、生长抑素对照组之间恢复排气时间无统计学意义(P>0.05)。结论:对于术后早期炎性肠梗阻可先行鼻胃管胃肠减压联用生长抑素治疗,治疗48 h效果不明显时则换用经鼻型肠梗阻导管减压联用生长抑素治疗,对怀疑发生绞窄性肠梗阻或者保守治疗无效的患者则应行手术治疗。

Clinical observation of early postoperative inflammatory small bowel obstrution with the therapy of somatostatin and the nasal ileus catheter

Objective:To probe into the curative effect of early postoperative inflammatory small bowel obstrutions with the therapy of somatostatin and the nasal ileus catheter.Method: Forty-three cases of early postoperative inflammatory small bowel obstrution,admitted by People's Hospital of Nanchuan District,Chongqing from September 2003 to November 2011,were respectively treated by following conservative treatments.One was group,was treated by combing somatostatin with the nasal ileus catheter decompression;one group(somatostatin control group),which was treated by combing somatostatin with nasogastric tube decompression;the another was the stomach tube control group,treated by means of a nasogastric tube decompression.Then contrast betweer these three clinic treatments were then assessed.Results: The fifteen cases of the treated group were all cured by way of conservative treatment.The time of abdominal pain remission was significantly shorter than other two groups.Any two of the three groups compare was statistically significant(P<0.05).It is obviously that treatment group and somatostatin control group was quicker to restore exsufflation than the stomach tube control group(P<0.05);while no significant difference was found between the treated group and somatostatin control group(P>0.05).Conclusions: For early postoperative inflammatory small bowel obstrution,somatostatin and nasogastric tube decompresssion can be first provided as a treatment;Somatostatin and the nasal ileus catheter depression can replace the former if there is no significant effect in 48 h.An operation must be given if the patient may suffer from strangulating intestinal obstruction or if conservative treatment fails.