术后早期炎性肠梗阻68例诊治分析

目的 探讨术后早期炎性肠梗阻的特点和诊断、治疗原则、预防措施.方法 回顾性分析68例术后早期炎性肠梗阻患者的临床资料.结果 65例患者经胃肠减压、抗炎、应用生长抑素、肾上腺皮质激素、全胃肠外营养、中医结合等保守治疗治愈,平均治愈时间14 d.3例手术治疗后痊愈,其中1例因保守治疗时出现绞窄性肠梗阻而手术,1例保守治疗4周无效行剖腹探查术,1例保守治疗耐心不够而手术.结论 术后早期炎性肠梗阻宜先采用保守治疗,且疗效满意.

Diagnosis and treatrment of 68 patients with early postoperative inflammatory small bowel obstruction

Objective To investigate the clinical features of early postoperative inflammatory small bowel obstruction,and discuss its diagnosis,treatment and preventive measures.Methods The clinical data of 68 cases of early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results Within the 68 cases,65 cases were cured by non-operative treatment including gastrointestinal decompression,anti-inflammatory drugs,somatostatin,total parenteral nutrition（TPN） and traditional Chinese medicine.The mean time from the onset of symptoms to the recovery of bowel function was 14 days.Three cases were cured by transferring to operation.One case of them was transferred to operation for strangulated intestinal obstruction during the period of conservative treatment.One case underwent operation because the patient didn＇t recover after 4 weeks expectant treatment.One case underwent operation for the impatience with the conservative treatment of both the doctors and the patient.Conclusion Non-operative therapy should be the first choice for the treatment of early postoperative inflammatory small bowel obstruction,and its therapeutical effect was well-accepted.