临床普外科电子杂志
臨床普外科電子雜誌
림상보외과전자잡지
Journal of General Surgery for Clinicians(Electronic Version)
2015年
2期
33-35
,共3页
逄锦忠%李宁波%徐超%王光军%孙文娟%薛建东%柴春%李政
逄錦忠%李寧波%徐超%王光軍%孫文娟%薛建東%柴春%李政
방금충%리저파%서초%왕광군%손문연%설건동%시춘%리정
术后早期炎性肠梗阻%诊断%治疗
術後早期炎性腸梗阻%診斷%治療
술후조기염성장경조%진단%치료
Early postoperative inflammatory small bowel obstruction%Diagnosis%Treatment
目的 探讨术后早期炎性肠梗阻的诊断和治疗.方法 回顾性分析2008年3月至2012年8月间收治的15例术后早期炎性肠梗阻的临床资料.结果 15例患者术后皆有肠功能一度恢复的表现,后大多数在两周内又出现梗阻症状,其中腹胀明显,腹痛相对较轻.14例患者经胃肠减压、抗炎、应用生长抑素等保守治疗治愈,平均治愈时间为18.5d,无1例肠坏死.1例保守治疗2周不见缓解,出现腹膜炎征象行剖腹探查,术中见小肠粘连导致血运障碍而行部分小肠切除术,术后2周治愈出院.结论 术后早期炎性肠梗阻有其特征性的临床表现,结合腹部X线及CT检查有助于其诊断,其中全腹CT检查对术后早期炎性肠梗阻的诊断具有重要的参考价值.治疗上应首先给予生长抑素为主的保守治疗,并严密观察,如出现肠坏死、腹膜炎征象时则应及时中转手术.
目的 探討術後早期炎性腸梗阻的診斷和治療.方法 迴顧性分析2008年3月至2012年8月間收治的15例術後早期炎性腸梗阻的臨床資料.結果 15例患者術後皆有腸功能一度恢複的錶現,後大多數在兩週內又齣現梗阻癥狀,其中腹脹明顯,腹痛相對較輕.14例患者經胃腸減壓、抗炎、應用生長抑素等保守治療治愈,平均治愈時間為18.5d,無1例腸壞死.1例保守治療2週不見緩解,齣現腹膜炎徵象行剖腹探查,術中見小腸粘連導緻血運障礙而行部分小腸切除術,術後2週治愈齣院.結論 術後早期炎性腸梗阻有其特徵性的臨床錶現,結閤腹部X線及CT檢查有助于其診斷,其中全腹CT檢查對術後早期炎性腸梗阻的診斷具有重要的參攷價值.治療上應首先給予生長抑素為主的保守治療,併嚴密觀察,如齣現腸壞死、腹膜炎徵象時則應及時中轉手術.
목적 탐토술후조기염성장경조적진단화치료.방법 회고성분석2008년3월지2012년8월간수치적15례술후조기염성장경조적림상자료.결과 15례환자술후개유장공능일도회복적표현,후대다수재량주내우출현경조증상,기중복창명현,복통상대교경.14례환자경위장감압、항염、응용생장억소등보수치료치유,평균치유시간위18.5d,무1례장배사.1례보수치료2주불견완해,출현복막염정상행부복탐사,술중견소장점련도치혈운장애이행부분소장절제술,술후2주치유출원.결론 술후조기염성장경조유기특정성적림상표현,결합복부X선급CT검사유조우기진단,기중전복CT검사대술후조기염성장경조적진단구유중요적삼고개치.치료상응수선급여생장억소위주적보수치료,병엄밀관찰,여출현장배사、복막염정상시칙응급시중전수술.
Objective To explore the diagnosis and treatment for the patients with early postoperative inflammatory small bowel obstruction (EPISBO).Methods The clinical data on 15 cases of EPISBO in our hospital from March 2008 to August 2012 were retrospectively analyzed.Results The intestinal function of all the 15 cases once recovered postoperatively, but the symptoms of bowel obstruction, such as obvious abdominal distention and mild abdominal pain, occurred mostly in two weeks. 14 cases had recovered after non-operative treatment including gastrointestinal decompression, administration of antibiotics and somatostatin, etc. The mean cure time was 18.5 days and none had intestinal necrosis. The other 1 case was not cured after the conservative treatment for 2 weeks. The laparotomy operation was performed due to peritonitis, and partial small bowel resection was given for blood supply obstacles and adhesion. This patient was cured after 2 weeks. Conclusion Early postoperative inflammatory small bowel obstruction has characteristic of clinical manifestations. The combination of clinical manifestations and abdominal X-ray and CT examinations contribute to the diagnosis of EPISBO, particularly for whole abdominal CT scan. Conservative treatments including somatostatin should be the first choice. Surgical intervention is imperative once intestinal necrosis or peritonitis happens.
