泛影葡胺对粘连性小肠梗阻的临床疗效

The effect of gastrografin therapy for adhesive small bowel obstruction

目的探讨泛影葡胺对粘连性小肠梗阻的诊断和治疗作用。方法回顾性分析2年半内收治的146例粘连性小肠梗阻患者的临床资料，随机分为泛影葡胺治疗组（治疗组，72例）与对照组（74例）。口服或经鼻胃管注入80～100mL76％的泛影葡胺注射液，注药后夹管2h，观察临床症状并结合腹部X线摄片、螺旋CT动态观察梗阻加重和缓解情况，比较两组患者发病至入院前时间，住院天数，住院费用，非手术治疗成功者入院后缓解时间，非手术治疗成功者发病至缓解时间，非手术治疗成功率，手术治疗者入院后非手术治疗时间及手术治疗者发病至手术时间。结果治疗组72例中50例（69．4％）非于术治疗成功，非手术治疗成功率为69．4％大于对照组的46．0％（34／74）（P〈0．05）；该50例非手术治疗成功者平均入院后缓解时间为（1．90±1．03）d短于对照组（3．20±1．95）d（P〈0．05），治疗组22例（30．6％）非手术治疗过程中症状加重而行手术治疗。治疗组的手术治疗者平均非手术治疗时间，平均仲院天数，平均住院费用等均少于对照组（P〈0．05）。结论口服或经鼻胃管注入泛影葡胺能提高粘连性小肠梗阻患者的非手术治疗成功率，并能加速粘连性小肠梗阻的缓解，缩短非手术治疗无效忠者的手术前非手术治疗时间，从而加快手术治疗的决定，缩短了患者的住院时间，降低了住院费用。

Objective To assess the therapeutic effect of gastrografin therapy in adhesive small bowel obstruction. Methods One hundred and forty-six patients with adhesive small bowel obstruction, during January 2007 and June 2009 , were randomized divided into receive gastrografin tretment group （ n = 72 ） and control group （n = 74 ）. Gastrografin therapy group received 80 - 100 mL of gastrografin either orally or via a nasogastrie tube. The time before admission, relief time of successful nonoperative treatment, time before operation of unsuccessful nonoperative treatment, obstruction relief rate, hospitalization time and cost of hospitalization were compared. Results In study group, 50 cases （69. 4% ） had successful outcome, which was higher than the 46.0% （ 34/74 ） of control group （ P 〈 0.05 ） ; the average symptomatic relief time was （1.90±1.03） d shorter than that of control group （3.20±1.95）d（P〈0.05）. Twenty-two cases （30.6%） of gastrografin therapy group were not relieved, The time before operation of unsuccessful nonoperative treatment, hospitalization time and cost of hospitalization were significantly less than that of controls （ P 〈 0. 05 ）. Conclusions Gastrografin therapy can increase the rate of successful nonoperative treatment, accelerates resolution of adhesive small bowel obstruction, and shorten surgical decision-making time for unsuccessful nonoperative treatment. It also can reduce the hospitalization time and cost of hospitalization.