术后早期肠梗阻的诊断和治疗

The Diagnosis and Treatment of Early Postoperative Small Bowel Obstruction

目的探讨腹部手术后早期肠梗阻的病因、临床特点和治疗方法。方法回顾性分析24例腹部手术后早期肠梗阻病例的临床资料。结果 24例中20例经禁食、抗炎、解痉、肠外营养、胃肠减压等保守治疗痊愈,缓解时间平均7d;4例再次手术,1例为内疝,2例为肠管壁疝,1例为束带形成。结论术后早期肠梗阻的特点:①多于术后3～30d开始出现梗阻症状。②以炎性肠梗阻多见,腹胀为主,腹痛较轻,较少发生绞窄。为腹腔炎症引起黏连所致,大多经保守治疗有效。③少数病例为机械性因素造成梗阻,多需手术解除梗阻。对绞窄性梗阻应及早手术。再次手术宜从简,以解决梗阻为目的。

Objective To investigate the etiopathogenisis, clinical characteristic, and treatment of early postoperative bowel obstruction. Methods The 24 case of early bowel obstruction were analysed retrospec- tively. Results The 20 cases were cured in the mean period of 7 days through non-operative treatment and the others subject to operative procedure , were cured in the mean period of 13.5 days. Conclusion The traits of early postoperative bowel obstruction： 1 } The cases of abdominal operation were occurring in early stage usually three to thirty days postoperatively{ 2）Mostly caused by extensive inflammations in and cured by non-operative but rare intestinal ischemia. Abdominal distension more prominent dominal pain. {3）A few of cases caused by mechanical factors must be cured by operation. abdomen than ab-