两次泛影葡胺鼻饲在判断粘连性肠梗阻手术指征中的意义

The significance of double nasogastric feeding with diatrizoate in judging surgical indication for adhestive intestinal obstruction

目的探讨两次泛影葡胺鼻饲在判断粘连性肠梗阻(ATO)手术指征中的意义。方法对30例经胃管两次注入泛影葡胺的粘连性肠梗阻病例资料进行回顾性分析。结果本组共30例患者,其中7例经第2次泛影葡胺给药后24 h内肠梗阻缓解,4例患者因怀疑或出现肠绞窄征象改为手术治疗。其余19例经两次泛影葡胺给药后肠梗阻仍未缓解、但无绞窄征象的病例接受了手术治疗。术中均发现了需要手术才能解决的粘连问题,经手术治疗效果满意。结论经两次泛影葡胺鼻饲后粘连性肠梗阻不能缓解者,尽管可能还未出现绞窄性肠梗阻的表现,也宜尽早手术。本研究结果为判断非绞窄性粘连性肠梗阻的手术指征提供了一个简单的方法。

Objective To explore the significance of double nasogastric feeding with diatrizoate in judging surgical indication for adhesive intestinal obstruction.Methods Clinical data of 30 patients with adhesive intestinal obstruction underwent double nasogastric feeding with diatrizoate were analyzed retrospectively.Results 30 patients were enrolled,7 patients relieved within 24 hours after second administration of diatrizoate,and 4 patients underwent operation because of the doubtful or evident signs of intestinal strangulation.The other 19 cases underwent operations without relief after second administration of diatrizoate,though there was no sign of strangulation.The adhesive lesions requiring surgery were found in all patients.The effect of surgery was satisfactory.Conclusion The patients should undergo operation as early as possible if that the signs of adhesive intestinal obstruction don’t relieve after double nasogastric feeding although no signs of strangulating intestinal obstruction appear.Our results provided a simple method to judge the surgical indication for adhesive intestinal obstruction without strangulation.