术后早期肠梗阻的诊断与治疗

The Diagnosis and Treatment of Early Postoperative Intestinal Obstruction

【目的】探讨术后早期肠梗阻的特点和诊断、治疗原则。【方法】对本院1995年1月至2005年12月收治的47例术后早期肠梗阻病人的临床资料进行回顾性分析。【结果】47例病人均治愈,未发生肠外瘘等严重并发症,无死亡病例。2例术后4-7个月再次发生肠梗阻,均经保守治疗治愈。【结论】腹腔术后早期可发生肠梗阻,诊断主要依靠病史、体征及腹部X线、CT检查。治疗方法的选择及手术时机的掌握是提高治疗效果的关键。术后早期肠梗阻应首先采用保守治疗,有肠绞窄或肠绞窄趋势时应及时手术。

[Objective]To discuss the principles of diagnosis and treatment of early postoperative intestinal obstruction. [Methods]The clinical data of 47cases of early postoperative intestinal obstruction treated from January 1995 to October 2005 were analyzed retrospectively. [Results]All the 41 cases were cured without severe complications such as intestinal fistula and no death. Recurrent intestinal obstruction occurred in 2 cases in 4-7 months after operation and all of them were cured by non-operative therapy. [Conclusion]Early intestinal obstruction may be caused after operation in abdomen. The diagnosis depends on the medical record, physical sign,abdominal plain X-ray film and computer-tomography. Therapeutic procedure and operative opportunity play an important role in the treatment of postoperative intestinal obstruction. Non-operative approach should be the first choice for early postoperative inflammatory intestinal obstruction. Active operative treatment should be considered in strangulation of bowel.