泛影葡胺在治疗粘连性不全性小肠梗阻中的应用

Application of Gastrografin in Treatment of Adhesive Partial Small Bowel Obstruction

目的评价泛影葡胺在治疗粘连性不全性小肠梗阻(APSBO)中的应用。方法对APSBO保守治疗48h无效的患者经胃管注入76%的泛影葡胺100ml,24h内到达结肠的继续保守治疗直至出院,24h未到达结肠的行手术治疗。结果本组72例经48h保守治疗,无效的25例经胃管注入100ml泛影葡胺,22例24h造影剂到达结肠继续保守治疗直至出院,3例24h造影剂未到达结肠行手术治疗,泛影葡胺能使88%(22/25)的患者避免手术。也将APSBO总体手术率从20%30%降到9.7%(7/72)。结论经胃管注入泛影葡胺是非手术治疗粘连性肠梗阻安全有效的方法,能减少这类病人的手术发生。

Objective To evaluate the application of Gastrografin in treatment of adhesive partial small bowel obstruction（ APS- BO）. Methods 100 ml of undiluted Gastrografin were given through the nasogastric tube to the ineffective cases in all patients received conservative management of 48 h. The conservative management will be taken for the cases which contrast medium reached the colon in 24 h, and surgery therapy for the cases which contrast medium failed to reach. Results Gastrografin was administered to the 25 cases which showed no improvement in the initial conservative management of 48h for all 72 patients with APSBO. There were 22 cases which the contrast medium reached colon in 24 h continued to undergo the conservative management until to leave hospital, and other 3 cases underwent surgery. The surgical intervention was avoided in 88% （22 of 25） cases who failed in conservative management by useof Gastrografin. Gastrografin also decreased the overall requirement rate for surgical management from the reported rate of 20 -30% to 9.7% （7 of 72）. Conclusions Gastrografin through the nasogastric tube is safe and effective in the means of non - operation for APSBO, and can reduce the need for surgical intervention.