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结直肠癌术后早期炎性肠梗阻的诊断和治疗
引用本文:白江江,宗新玲,高维东,曹光材,霍爱鑫. 结直肠癌术后早期炎性肠梗阻的诊断和治疗[J]. 中国现代医学杂志, 2020, 30(10): 67-70
作者姓名:白江江  宗新玲  高维东  曹光材  霍爱鑫
作者单位:(延安大学附属医院 1. 肛肠外科,2. 免疫风湿科,陕西 延安 716000)
摘    要:术后早期炎性肠梗阻(EPISBO)是胃肠道手术后常见的并发症,结直肠癌术后EPISBO 的发病率为4% ~ 15%。EPISBO 发病机制复杂,纤溶系统平衡破坏、神经反射、炎症反应及药物的相互作用可能是其主要机制。EPISBO 的治疗应尽可能采用保守治疗,术前完善肠道准备,术中减少肠道损伤及肠内容物外溢,减少腹腔污染的机会,术中适当应用防粘连剂,术后抑制炎症反应可预防EPISBO。

关 键 词:结直肠肿瘤;肠梗阻;创伤诊治中心;综述
收稿时间:2019-11-23

Current status of diagnosis and treatment of early inflammatorybowel obstruction after colorectal cancer surgery
Jiang-jiang Bai,Xin-ling Zong,Wei-dong Gao,Guang-cai Cao,Ai-xin Huo. Current status of diagnosis and treatment of early inflammatorybowel obstruction after colorectal cancer surgery[J]. China Journal of Modern Medicine, 2020, 30(10): 67-70
Authors:Jiang-jiang Bai  Xin-ling Zong  Wei-dong Gao  Guang-cai Cao  Ai-xin Huo
Abstract:Academician, Jie-shou Li, put forward early postoperative inflammatory small bowel obstruction(EPISBO) for the first time on national gastrointestinal surgery conference in the 1995, and expounded the cause,characteristics, diagnosis and treatment of EPISBO. EPISBO is a common complication of colorectal cancer after operation,and certain literatures reported that the incidence of EPISBO after colorectal cancer surgery ranged from 4% to 15%. Thepathogenesis of EPISBO is complex, and fibrinolytic system, neural reflex, inflammation, and drug interactions may bethe pathogenesis of EPISBO. There is no consensus on diagnosis and management of EPISBO. EPISBO is different fromother types of postoperative intestinal obstruction, and has its unique characteristics of diagnosis and treatment. EPISBOrequires appropriate management with a proper diagnostic and therapeutic pathway. Indication and length of Non-operativetreatment and appropriate timing for surgery may represent an insidious issue. Non -operative management should beattempted in absence of signs of peritonitis or strangulation; combining traditional with western medicine comprehensivetreatment can obtain satisfactory curative effect. Improvement in the preoperative bowel preparation, intraoperative lesstrauma and intestinal contents to overflow, the opportunity to reduce the pollution of the abdominal cavity, anti-adhesionagent, postoperative inhibit inflammation can prevent EPISBO.
Keywords:colorectal neoplasms   intestinal obstruction   diagnosis and treatment   review
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