急性粘连性小肠梗阻的诊治体会

Diagnosis and treatment of acute adhesiveness small bowel obstruction

目的 探讨急性粘连性小肠梗阻的诊断和治疗方法 .方法 回顾性分析2002年3月至2007年3月间77例急性粘连性小肠梗阻的诊断治疗过程,分析急性粘连性小肠梗阻的最佳治疗方案.结果 77例急性粘连性小肠梗阻患者行非手术治疗47例,治愈38例;手术治疗30例,治愈23例.两种治疗方法 治愈率无差别（P〉0.05）.随访到的69例出院患者中复发23例（33.33%）,且非手术治疗的复发率高于手术治疗（P=0.04）.反复发作的粘连性小肠梗阻的复发病例均为非手术治疗.结论 急性粘连性小肠梗阻在保守治疗过程中应密切观察病情发展,如无效或有加重趋势应积极手术;反复发作患者早期及时手术治疗是最有效手段.

Objective To investigate the diagnosis and treatment of acute adhesiveness small bowel obstruction （AASBO）. Methods The diagnosis and treatment of 77 cases of AASBO were retrospectively analyzed in the past 5 years. Results Among these 77 patients, 47 received non -operative treatment （38 cured） ; 30 received surgical treatment（23 cured）. The rates of cured were no different between these two treatments （P 〉 0. 05 ）. 23 cured patients recurred ileus （33.33 % ）, and the recurrence rate was higher in non -operative treatment group than in surgical treatment group （P = 0. 0407 ）. The relapsed eases in recurrent attacks patients all were in in surgical treatment group. Conclusion In the period of conservative treatment for AASBO, we should observe the progression of disease closely. Early and timely surgical treatment was the most effective procedure in recurrent attacks patients.