胃肠肿瘤术后肠梗阻的临床特点及处理分析

目的探讨胃肠肿瘤术后肠梗阻的临床特点及保守治疗方法。方法回顾性分析2005年1月至2012年1月我科收治的69例胃肠肿瘤术后肠梗阻患者的原发部位、梗阻类型、原发肿瘤分化、分期与良、恶性梗阻的关系,以及常规治疗与加用奥曲肽保守治疗疗效比较。结果 69例肠梗阻中,23例恶性肠梗阻,46例良性肠梗阻,原发肿瘤分化较差、分期较晚者更多发生恶性肠梗阻(P<0.01);恶性肠梗阻多为不全性肠梗阻,而完全性肠梗阻多发生在良性肠梗阻患者(P<0.05);肠梗阻保守治疗加用奥曲肽疗效高于常规治疗组(P<0.05)。结论肠梗阻类型、原发肿瘤分化、分期可作为判断梗阻良恶性病因的因素之一。对肠梗阻的保守治疗,在既往常规治疗的基础上加用奥曲肽是一个即安全又有效的方法。

Clinical Features and Analysis of Gastrointestinal Tumors and Treatment of Postoperative Ileus

Objective To investigate the clinical characteristics of gastric cancer postoperative Intestinal obstruction and conservative treatment method. Methods a retrospective analysis from January 2005 to January 2012 our department treated 69 cases of gastric cancer postoperative Intestinal obstruction patients of primary site, the types of obstruction, primary tumor differentiation, relations with benign and malignant obstruction in stages, and regular treatment and combined with the octreotide compared curative effect of conservative treatment. Results In 69 cases of intestinal obstruction, 23 cases of malignant obstruction, 46 cases of benign intestinal obstruction, poor primary tumor differentiation, staging occurs late more malignant obstruction（P＆lt;0.01）;Malignancy intestinal obstruction for incomplete Intestinal obstruction, and more complete intestinal obstruction occurred in patients with benign intestinal obstruction（P＆lt;0.05）;Intestinal obstruction treated conservatively and with Mr Song peptide curative effect than conventional treatment group（P＆lt;0.05）. Conclusion Intestinal obstruction type, primary tumor differentiation, staging can be as one of judge obstruction factors of benign and malignant causes. Conservative treatment of intestinal obstruction, in the past on the basis of conventional treatment combined with Mr Qu peptide is a safe and effective method.