术后早期炎性肠梗阻30例诊治体会

Experience of diagnosis and treatment of 30 cases of early postoperative inflammatory ileus

目的总结术后早期炎性肠梗阻的临床特点及治疗原则。方法回顾性分析我院近4年来收治的30例术后早期炎性肠梗阻患者的临床资料。结果27例患者均经保守治疗痊愈,平均住院时间21d,3例经保守治疗28d无效而手术,其中1例治愈,1例术后并发肠瘘,经再次手术后治愈,1例并发腹腔脓肿,经腹腔引流治愈。结论术后早期炎性肠梗阻多发生在术后15d以内,应以保守治疗为主,手术治疗的并发症较多,疗效差,宜慎重。

[Objective] To summarize the clinical characteristic and therapeutic principle of early postoperative inflammatory ileus （EPII）. [Methods] The clinical data of 30 patients with early postoperative inflammatory ileus who were hospitalized in our hospital in recent 4 years were retrospectively investigated. [Results] 27 of 30 cases recovered after conservative treatment with average stay of 21 days. 3 cases underwent operation after vain conserva- tive treatment of 28 days. 1 case was cured.1 case was complicated by postoperative intestinal fistula and was cured through re-operation. 1 case was complicated by postoperative intraperitoneal abscess and was cured by abdominal cavity drainage.[Conclusion] Early postoperative inflammatory ileus mainly occurs 15 days after operation. Conservative treatment should be first choice and surgical strategy should be paid special attention because of more postoperative complication and no good curative effect.