营养支持在术后早期炎性肠梗阻治疗中的应用

Non-surgical management of early postoperative inflammatory small bowel obstruction

目的 探讨术后早期炎性肠梗阻治疗中营养支持及生长抑素和肾上腺皮质激素的应用价值及经验。方法 回顾性总结我院 1 987年 1 2月～ 2 0 0 3年 1 2月间 1 1 7例术后早期炎性肠梗阻病人的营养支持、生长抑素和肾上腺皮质激素的应用情况及疗效。结果 1 1 7例中有 1 1 6例治愈 ,平均治疗时间 2 8.71± 1 2 .1 6d。全组病人无一例在治疗过程中出现营养状况恶化。 1 0例早期肠内营养的病人中有 9例耐受良好。结论 非手术治疗方案是治疗炎性肠梗阻安全、有效的方法 ;营养支持、生长抑素及肾上腺皮质激素对于控制症状。

Objective To investigate the effectiveness of early postoperative inflammatory small bowel obstruction treatment using non surgical approach with nutritional support,somatostatin analogues,and corticoids.Methods A total of 117 consecutive patients were retrospectively studied.The usage and the clinical effect of nutritional support,somatostatin,and corticoids were reviewed. Among the 117 patients enrolled,116 were cured.The average treatment time was 28.71 ± 12.16 days.TPN support was performed in 115 patients for a mean time of 17.23 ± 8.96 days,with no patients aggravated in nutritional status.For the 10 patients treated with early enteral nutrition,9 tolerated well.Somatostatin and dexamethasone had a significant effect on reducing digestive juice loss and shortening patient's hospital stay.Conclusion Non surgical management with nutritional support and hormone therapy was effective in controlling symptoms and promoting recovery for the patients with early postoperative inflammatory small bowel obstruction.