重视腰椎外伤手术患者的胃肠道症状

Gastrointestinal symptoms after lumbar injury and operation

腰椎外伤和腰椎手术患者由于腹膜后血肿和手术刺激腹腔神经丛导致不同程度的胃肠功能障碍.严重者出现肠麻痹和腹膜炎,患者出现严重腹胀、腹痛、不能进食.在此基础上术后应用抗生素时易出现抗生素相关性腹泻,严重者出现重度伪膜性肠炎.由于骨科医师对伪膜性肠炎不认识,消化科医师又对伪膜性肠炎可出现腹腔内高压甚至腹腔间隔室综合征不认识或重视观察处理不够,错过了在腹腔内高压时段抢救的最佳时机,导致患者死亡,因此对腰椎外伤和腰椎手术患者要高度重视早期胃肠道症状,及时发现抗生素相关性腹泻,尤其重度伪膜性肠炎的出现.重视腹腔内高压的有效处理,防止腹腔间隔室综合征的出现,降低死亡率.

Lumbar injury and operation can lead to different stomach intestine functional disturbances and severe conditions can lead to enteroparalysis and peritonitis owing to retroperitoneal hematoma and stimulation of the coeliac plexus, causing severe abdominal distention, abdominal pain and an inability to take food. These are the main factors associated with antibiotic-associated diarrhea and severe pseudomembranous colitis owing to the use of antibiotics. The reasons for death are generally due to osteopathic incognizanting pseudomembranous colitis and the doctors of gastrointestinal departments for not recognizing or treating in a timely manner intra-abdominal hypertension leading to pseudomembranous colitis, which is the best period to save a patient. Abdominal compartment syndrome is also a reason. Therefore, attention should be paid to early gastrointestinal symptoms after lumbar injury and operation, specifically, antibiotic-associated diarrhea and severe pseudomembranous colitis, to effectively treat intra-abdominal hypertension, prevent abdominal compartment syndrome and reduce mortality.