术后肠梗阻的诊断及治疗(附137例报告)

目的探讨术后肠梗阻的特点和诊断、治疗原则。方法对南京军区南京总医院2001年1月至2004年10月收治的137例术后肠梗阻病人的临床资料进行回顾性分析。结果137例病人均治愈,未发生肠外瘘等严重并发症,无死亡。2例发生术后早期炎性肠梗阻,2例术后3~8个月再次发生肠梗阻均经保守治疗而治愈。结论腹腔术后可出现肠梗阻,诊断主要依靠病史、体征及腹部X线、CT检查。治疗方法的选择及手术时机的掌握是提高治疗效果的关键。术后早期炎性肠梗阻应采用保守治疗,肠绞窄或有肠绞窄趋势应及时手术,反复发作的粘连性肠梗阻应积极手术。

Diagnosis and treatment of postoperative intestinal obstruction:a report of 137 cases

Objective To investigate the principles of diagnosis and treatment of postoperative intestinal obstruction.Methods The clinical data of 137 cases of postoperative intestinal obstruction treated from January 2001 to October 2004 were analyzed retrospectively.Results All the 137 cases were cured without severe complications such as intestinal fistula and no death.The early postoperative inflammatory intestinal obstruction was occurred in 2 cases.Recurrent intestinal obstruction was occurred in 2 cases in 3-8 months after operation and all of them were cured by non-operative approach.Conclusions Intestinal obstruction can be caused by operation in abdomen.The diagnosis depends on the medical history,clinical manifestations, abdominal plain X-ray and computed tomography.Therapeutic procedure and operative opportunity play an important role in the treatment of postoperative intestinal obstruction.Non-operative approach should be the first choice for early postoperative inflammatory intestinal obstruction.Prompt surgery is clearly indicated and valuable for acute or being strangulative obstruction.Active operative treatment should be considered in recurrent chronic intestinal obstruction.