复方泛影葡胺对粘连性小肠梗阻早期手术的预测

Oral Urografin study predicts the need for early surgery in postoperative adhesive intestinal obstruction

目的探讨口服76％复方泛影葡胺24小时后腹部平片对粘连性小肠梗阻治疗方法的选择是否可作为一个可靠指征。方法对171例无绞窄情况的粘连性肠梗阻患者进行了本研究。40ml 76％复方泛影葡胺+40ml 蒸馏水口服或经胃管注入。4、8、16、24小时拍腹部平片。如果4小时腹部平片升结肠显影,后序平片无需再拍。结果24小时内造影剂到达结肠120例(70％),这些病人均成功地进行了保守治疗。51例病人24小时内造影剂未到达结肠,49例进行了手术治疗,2例保守治疗。结论 24小时内结肠显影的病人均成功地进行了保守治疗。提示口服复方泛影葡胺后24小时造影剂未到达结肠者需患诊手术治疗。

To determine whether a 24-hour radiograph after oral Urografin is a reliable indicator for opera- tion in patients with adhesive small bowel obstruction.Methods 171 patients with adhesive small bowel obstruction under- went this study.Each patient administered 40ml 76% Urografin solution mixed with 40ml distilled water,after 4,8,16 and 24 hour,some plain abdominal radiographs were taken.If an early plain abdominal radiograph showed that Urografin had reached the ascending colon,subsequent radiographs were not taken.Results Urngrafin had reached the colon within 24 hour in 120 patients(70 per cent),those patients were treated with nonoperative methods.In 51 cases(30 per cent) Urografin was not observed in the colon within the first 24 hour,49 patients performed operation,non-operative manage- ment was given in two.Conclusion All patients with evidence of Urografin reaching the colon within 24 hour were treated with nonoperative methods successfully.The result suggests that patients with adhesive small bowel obstruction in whom Urografin fails to reach the colon within 24 hour should receive surgical treatment.