CAJ | 학술논문

目的评价经鼻置入小肠减压管行小肠减压、并注入泛影葡胺行小肠造影在术后早期炎性肠梗阻治疗中的作用.方法首都医科大学附属北京同仁医院普通外科于2011年4月至2012年7月间有12例腹部手术患者术后早期出现炎性肠梗阻,经鼻胃管减压等常规保守治疗2周后,肠梗阻症状改善不明显,遂经鼻置入小肠减压管行小肠减压,同时经减压管注入泛影葡胺行小肠造影,了解小肠蠕动情况及肠道梗阻情况,并利用泛影葡胺促进肠蠕动的治疗作用,观察其治疗效果.结果在置入小肠减压管后,12例患者腹胀症状均有所缓解,其中11例在置入小肠减压管后3周内腹部坚韧感消失,恢复正常排气并逐渐开始经口进食;1例患者在50 d后仍未排气,再次行手术治疗,术后3d患者恢复自主排气.随访6个月,全组患者无一例复发肠梗阻.结论对于症状较重、病程较长并经常规处理无效的术后早期炎性肠梗阻患者,应用小肠减压管行小肠减压并注入泛影葡胺行小肠造影的方法安全有效,能够避免二次手术.
목적 평개경비치입소장감압관행소장감압、병주입범영포알행소장조영재술후조기염성장경조치료중적작용.방법 수도의과대학부속북경동인의원보통외과우2011년4월지2012년7월간유12례복부수술환자술후조기출현염성장경조,경비위관감압등상규보수치료2주후,장경조증상개선불명현,수경비치입소장감압관행소장감압,동시경감압관주입범영포알행소장조영,료해소장연동정황급장도경조정황,병이용범영포알촉진장연동적치료작용,관찰기치료효과.결과 재치입소장감압관후,12례환자복창증상균유소완해,기중11례재치입소장감압관후3주내복부견인감소실,회복정상배기병축점개시경구진식;1례환자재50 d후잉미배기,재차행수술치료,술후3d환자회복자주배기.수방6개월,전조환자무일례복발장경조.결론 대우증상교중、병정교장병경상규처리무효적술후조기염성장경조환자,응용소장감압관행소장감압병주입범영포알행소장조영적방법안전유효,능구피면이차수술.
Objective To evaluate the role of the small intestinal decompression tube (SIDT) and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO).Methods Twelve patients presented EPISBO after abdominal surgery in our department from April 2011 to July 2012.Initially,nasogastric tube decompression and other conventional conservative treatment were administrated.After 14 days,obstruction symptom improvement was not obvious,then the SIDT was used.At the same time,Gastrografin was injected into the small bowel through the SIDT in order to demonstrate the site of obstruction of small bowel and its efficacy.Results In 11 patients after this management,obstruction symptoms disappeared,bowel function recovered within 3 weeks,and oral feeding occurred gradually.Another patient did not pass flatus after 4 weeks and was reoperated.After postoperative follow-up of 6 months,no case relapsed with intestinal obstruction.Conclusion For severe and long course of early postoperative inflammatory intestinal obstruction,intestinal decompression tube plus Gastrografin is safe and effective,and can avoid unnecessary reoperation.