术后早期炎性肠梗阻诊治分析

Analysis of the diagnosis and treatment of early postoperative inflammatory small bowel obstruction

目的：探讨术后早期炎性肠梗阻的病因、临床表现、诊断及治疗。方法：回顾性分析25例术后早期炎性肠梗阻患者的临床资料。结果：22例行保守治疗治愈，平均治愈时间10．3d，手术治疗3例，其中2例行肠黏连松解术，1例行大部分小肠切除术。术后出现切口感染1例，术后并发长期腹泻及营养不良1例。结论：术后早期肠梗阻多发生于术后1～2周，与手术操作广泛、手术创伤大有关。典型症状为肠梗阻表现，治疗首选保守疗法，如保守治疗无效或有肠绞窄可能时应手术治疗，手术方式应力求简单有效。

Objective To discuss the etiological factor,clinical situation ,diagnosis and therapy of early postoperative inflammatory small bowel obstruction. Methods Twenty-five cases of the clinical data were analyzed retrospectively. Results Twenty-two cases were all cured in a mean period of 10. 3 days by non-operative therapy. Three cases received operations including 2 enterolysis and 1 section intestinal resection, an infection of incisional wound occurred in 1 case and long time diarrhoea and malnutrition occurred in 1 case. Conclusion Early postoperative inflammatory small bowel obstruction mainly occurs in about 1 ～ 2 weeks after operation and is related to extensive operation and insult. Early postoperative inflammatory small bowel obstruction has typical signs and symptoms of bowel obstruction. If conservative therapy isn＇t effective or strangulation of bowel occurs, operation should be adopted and operation style should be simple and effective.