术后早期炎性肠梗阻的诊疗体会

目的探讨术后早期炎性肠梗阻的临床特点及治疗方法。方法回顾15例术后早期炎性肠梗阻患者的治疗方法,包括禁食、胃肠减压、全肠外营养、糖皮质激素和生长抑素的应用,结合文献进行分析探讨。结果保守治疗组全部治愈,平均治愈时间21d,无一例肠坏死;手术治疗组痊愈1例,死亡1例。结论术后早期炎性肠梗阻应尽可能采用非手术治疗,但怀疑有肠绞窄或继发腹腔脓肿应采用手术治疗。多数病例采用保守疗法可治愈。

Experiences in the treatment of early postoperative inflammatory small bowel obstruction

Objective To investigate the principles of diagnosis and treatment of early postoperative inflammatory small bowel obstruction(EPISBO). Methods A retrospective study was made on the treatment of 15 patients with EPISBO. Treatment included fasting, gastrointestinal decompression, total parenteral nutrition, glucocorticoid and somatostatin. In 15 cases of EPISBO, 13cases received nonoperative therapy and 2 cases received operative therapy. Results All cases were all cured in the mean period of 21 days through nonoperative therapy; and 1 case were cured and 1 case died in operative group. Conclusions EPISBO should be treated with nonoperaive therapy if suitable. Operative therapy should be taken when suspected bowel strangulation or continuous abdominal cavity abscess occur. Conservative treatment should be the first choice for EPISBO patients.