医用纤维蛋白胶致肠梗阻三例报告

Medical Fibrin Glue Causing Intestinal Obstruction:a Report of 3 Cases

目的：提高医用纤维蛋白胶（FG）的临床应用安全性。方法：对3例腹部手术中使用FG术后出现粘连性肠梗阻临床资料进行回顾分析，分析原因并提出预防措施。结果：3例系2004～2005年手术病例，占同期我院腹部手术使用FG者的5．36％，分别在肠修补术、胃大部切除术中于吻合口处使用1组FG，术后17天、26天及4个月出现肠梗阻表现，再次剖腹探查证实原使用FG处形成干酪样白色块状物，局部形成粘连性肠梗阻，术后病理证实干酪样白色块状物为胶样结构及纤维结缔组织：结论：FG使用不当可致肠梗阻，临床医生应引起重视，对腹部手术中使用FG后出现粘连性肠梗阻者应考虑是否与本品有关、

Objective ： To improve the safety of clinical application of medical fibrin glue. Methods ： Clinical data and reflections of 3 cases of adhesive ileus after using fibrin glue in abdominal operations were retrospectively analyzed and preventive measures were provided. Results：The 3 cases occurred during 2004-2005, making up 5.36% of all such cases. A packet of FG was used respectively in intestinal neoplasty and subtotal gastreetomy. Intestinal obstruction occurred 17d,26d and 4 mouths after operation. The exploratory laparotomy found a clot of white cheese like substance in the spot of FG application. Local adhesive ileus was also found. Postoperative pathological test proved that the cheese like substance was glue texture and fibrous connective tissues. Conclusion：Improper use of FG may result in IO. Adhesive ileus after abdominal operations may be associated with using FG.