玻璃酸钠应用于粘连性肠梗阻治疗的临床观察

A clinical evaluation of sodium hyaluronate in treating adhesive intestinal obstruction

目的观察玻璃酸钠治疗粘连性肠梗阻的临床效果。方法 30例粘连性肠梗阻患者在进行粘连松解术中,将医用玻璃酸钠(施沛特)10 ml稀释于100 ml生理盐水中,留置于肠管之间,然后将3-5 ml施沛特涂抹于粘连松解部位、浆膜粗糙部位及腹膜切口处(肠腹膜损伤处)。结果全部患者顺利度过围手术期,术后排气时间平均为36．8 h,术后无肠梗阻症状,平均随访525 d,1例于手术后156 d再次行粘连松解术,2例于术后121、68 d再次入院行保守治疗,症状消失后出院。 2例随访期间内偶发脐周疼痛,但无梗阻征象,未行治疗。其它患者随访期内均无肠梗阻症候群。结论玻璃酸钠在对粘连性肠梗阻治疗中能够有效地减少再梗阻的发生率,改善患者预后。

Objective To observe the clinical effect of sodium hyaluronate on treating adhesive intestinal obstruction. Methods Thirty patients with adhesive intestinal obstruction were performed with surgical separation of adhesion. 10 ml medical sodium hyaluronate （Sofast） was diluted in 100 ml of normal saline and detained in intestinal canal. 3-5 ml of sodium hyaluronate （Sofast） was sprayed on the lesions of intestine and peritoneum. Results All patients lived through perioperative period and postoperative timing of exhaust was medially 36.8 hours. No symptoms of intestinal obstruction occurred postoperatively. After following up for mean 525 days, 1 case was reoperated at the 156th days postoperatively; 2 cases were conservatively treated again at the 121st and 68th days; 2 cases caught bellyache occasionally, but did nothing because of no sign of intestinal obstruction. Others disappeared intestinal obstruction symptoms during the follow-up period. Conclusions Sodium hyaluronate is effective and safe in the treatment of adhesive intestinal obstruction.