慢性放射性肠炎并发肠梗阻的治疗

目的探讨放射性肠炎并发肠梗阻的治疗方法及临床效果。方法对2001年8月至2006年12月间收治的51例慢性放射性肠炎并发肠梗阻患者的临床资料进行总结。结果本组患者放射性肠炎并发肠梗阻均为肿瘤切除后盆腔、腹腔接受放射治疗所致,从放疗结束到肠梗阻症状出现的时间为(11.9±22.6)个月。分别采用了保守治疗(方案包括禁食、胃肠减压、抑制消化液分泌、营养支持、灌肠、补液、对症等,对于有感染征象的患者选用敏感的抗生素)、肠切除吻合术、肠造口术及短路手术。2例患者因肿瘤广泛转移未行有效手术治疗,1例患者术后因腹腔出血死亡,48例患者得到治愈,治愈率达94.1%。结论慢性放射性肠炎并发肠梗阻的治疗方案应该根据患者的营养状况及肠管损伤情况进行选择。

Management of chronic radiation enteritis with intestinal obstruction

OBJECTIVE: To explore the therapeutic method and efficiency of chronic radiation enteritis with intestinal obstruction. METHODS: Clinical data of 51 patients of chronic radiation enteritis with intestinal obstruction from Aug. 2001 to Dec. 2006 were analyzed retrospectively. RESULTS: The mean time from the ending of radiation to the occurrence of obstruction was (11.9 +/- 22.6) months. Conservative treatment, intestinal resection-anastomosis, enterostomy, bypass operation and enterolysis were applied and performed in above 51 cases. Two patients could not receive operation because of wild metastasis. One died of peritoneal bleeding after operation. Forty-eight cases were cured and the curative rate was 94.1%. CONCLUSION: Therapeutic regimen should be chosen according to nutritional status and intestinal impairment in chronic radiation enteritis with intestinal obstruction.