剖宫产术后急性结肠假性梗阻诊治分析

Acute Colonic Pseudo-Obstruction after Cesarean Section Diagnosis and Treatment:a Report of 14 Cases

目的分析剖宫产术后并发急性结肠假性梗阻临床特点,为临床进一步诊断治疗提供帮助。方法回顾性分析14例剖宫产术后并发急性结肠假性梗阻患者的临床表现、治疗方式和治疗结果等临床资料。结果 14例患者肠梗阻发作时间为剖宫产术后2～5 d,均有机械性肠梗阻的临床表现,主要以进行性腹胀为主要特点,较少剧烈腹痛,极少有肠坏死和穿孔并发症。11例患者经胃肠减压、禁食水、生长抑素静注和灌肠等保守治疗治愈,3例保守治疗效果欠佳,经结肠镜减压后痊愈,无死亡病例。结论剖宫产术后急性结肠假性梗阻绝大多数为功能性梗阻,可通过保守治疗和结肠镜减压等非手术方法治愈,预后良好,应与器质性结肠梗阻相鉴别,避免不必要的剖腹探查。

Objective To analyze the the clinical characteristics of acute colonic pseudo-obstruction after cesarean section, and to provide help for clinical diagnosis and treatment. Methods Retrospective analysis the clinical data of the clinical manifes- tations ,ways of therapy and treatment results of 14 cases with diagnosed acute colonic pseudo-obstruction after cesarean section was performed. Results All patients obstruction attack after cesarean section time for 2 - 5 days, had the clinical manifestations of mechanical obstruction, mainly with progressive abdominal distension as the main characteristics, and less severe abdominal pain,with very few intestinal necrosis and perforation complications. 11 patients after conservative treatment of gastrointestinal de-compression,fasting cure,somatostatin intravenous injection and enema and cured, 3 cases with the inefficiency of conservative treatment, which were healed by colonoscopy decompress. All patients were cured and with no death. Conclusion Most of the a- cute colonic pseudo-obstruction after cesarean section were functional obstruction, which could be cured through nonoperative method of the conservative treatment and colonoscopy decompress ,the prognosis of which was good ,which should be distinguished with organic obstruction, and unnecessary exploratory laparotomy should be avoided.