术后早期肠梗阻的诊断和治疗

目的探讨腹部手术后早期肠梗阻的病因、临床特点和治疗方法。方法回顾性分析24例腹部手术后早期肠梗阻病例的临床资料。结果 24例中20例经禁食、抗炎、解痉、肠外营养、胃肠减压等保守治疗痊愈,缓解时间平均7d;4例再次手术,1例为内疝,2例为肠管壁疝,1例为束带形成。结论术后早期肠梗阻的特点:①多于术后3～30d开始出现梗阻症状。②以炎性肠梗阻多见,腹胀为主,腹痛较轻,较少发生绞窄。为腹腔炎症引起黏连所致,大多经保守治疗有效。③少数病例为机械性因素造成梗阻,多需手术解除梗阻。对绞窄性梗阻应及早手术。再次手术宜从简,以解决梗阻为目的。

The Diagnosis and Treatment of Early Postoperative Small Bowel Obstruction

Objective To investigate the etiopathogenisis,clinical characteristic,and treatment of early postoperative bowel obstruction.Methods The 24case of early bowel obstruction were analysed retrospectively.Results The 20cases were cured in the mean period of 7days through non-operative treatment and the others subject to operative procedure,were cured in the mean period of 13.5days.Conclusion The traits of early postoperative bowel obstruction:(1) The cases of abdominal operation were occurring in early stage usually three to thirty days postoperatively(2) Mostly caused by extensive inflammations in abdomen and cured by non-operative but rare intestinal ischemia.Abdominal distension more prominent than abdominal pain.(3) A few of cases caused by mechanical factors must be cured by operation.