摘要
目的腹部手术后早期发生的肠梗阻原因较复杂,处理亦较困难,尤其是炎性肠梗阻,既有麻痹性因素,亦有机械性因素,使外科医师的医疗决策难以取舍,如是否需要手术、手术的时机、以及手术可能造成的并发症等均值得探讨。我科自1987年至1996年12月共收治了重型术后炎性肠梗阻48例,40例(83.3%)经非手术治疗痊愈;7例(14.6%)于症状消退后择期手术治疗并存症后治愈,1例2.1%死亡,临床非手术治疗时间为9～58天,平均27.6±10天,取得较满意的结果,为这种类型的肠梗阻治疗提供了一些经验。
Objectives:The cause,indications for surgery,operative procedure,early and late sequelae of surgery for patients with early abdominal postoperative inflaminatory small bowel obstruction are controversial. Methods This paper enrolled 48 pationts with an early abdominal postoperative inflammatory small bowel obstruction from 1986 to 1996.A trial of conservative treatment with nasogastric decompression,TPN and sandostatin was performed.Results 40 patients(83%)was successful without operation.7 patients(15%) were operated selectively after subsidence of acute symptoms because the patient company with intestinal fistulea or machnical small bowel obstruction,one patient died clue to pulmonary embolism.Conclusions Because reoperation complication is very high in patents with early abdominal postoperative inflammatory small bowel obstruction,the nonoperative treatment is the managment of choice,if there is no evidence of strangulation.
