结直肠癌术后早期炎性肠梗阻的临床特点与治疗

目的:探讨结直肠癌术后早期炎性肠梗阻的发病原因、临床特点和中医治疗特色。方法:回顾性分析1998—2004年21例结直肠癌术后早期炎性肠梗阻的临床特点和中西医结合治疗方法。结果:21例术后早期炎性肠梗阻经禁食、胃肠减压、全肠外营养支持以及中药复方大承气汤保留灌肠、吴茱萸加粗盐炒热布包热敷腹部等中西医结合治疗方法,痊愈20例,中转手术1例。平均发生时间是术后9.2天,平均治愈时间12.6天。结论:结直肠癌术后早期炎性肠梗阻多发生在术后1周左右,临床上有典型的肠梗阻症状和体征,但以腹胀和肛门停止排气排便为主,腹痛和呕吐相对较轻。可能的发病原因是手术创伤、腹腔内炎症、积液积血或异物刺激导致术后小肠出现炎性水肿,浆膜表面渗出增加,产生一系列免疫反应,造成腹膜间粘连而成。采用中西医结合疗法可获得满意疗效。

Clinical Characteristics and Treatment of Early Postoperative Inflammatory Bowel Obstruction in Colorectal Cancer

Objective:To explore the cause,clinical characteristics and Chinese medical treatment features of early postoperative inflammatory bowel obstruction in colorectal cancer.Methods:A total of 21 cases with early postoperative inflammatory bowel obstruction in colorectal cancer in our hospital during a period from 1998 to 2004 were involved in this study.The clinical characteristics and treatment method of integrated traditional and western medicine were analyzed retrospectively.Results:Treated by fasting,decompressing stomach and intestines,nutritional supporting outside intestines,reserve clyster with decoction of Dachengqi Decoction,external application of hot medicated pad over abdomen,20 were cured and 1 was transferred to operation in 21 cases.Average occurrence time is 9.2 days after operation and average cured time is 12.6 days.Conclusion:Early postoperative inflammatory bowel obstruction in colorectal cancer usually occurs in about a week after operation.The clinical features are typical systemic sighs and symptoms of bowel obstruction,but feeling windy and anus without exhaust and defecating can be observed mainly and abdominal pain and vomiting are relatively light.It is possible reason that surgical ravage,celiac inflammation,accumulated water and blood or eyewinker stimulating result in postoperative small bowel having phlogistic oedema,chorion surface increasing effusion and a series of immune reaction occurring,which leads to conglutination among peritoneum.Satisfied curative effect can be obtained by using treatment of integrated traditional and western medicine.