腹腔镜术后早期炎性肠梗阻的原因及处理措施

The causes and treatment measures of early postoperative inflammatory intestinal obstruction after Laparoscopic operation

目的探讨腹腔镜术后早期炎性肠梗阻的原因和处理措施，提高腹腔镜手术治疗的效果。方法于2004年1月一2015年6月选取我院普外科腹腔镜手术后早期炎性肠梗阻患者42例，回顾性分析42例患者腹腔镜早期炎性肠梗阻的原因，主要采取禁食、胃肠减压、补液维持水电解质和酸碱平衡、早期全胃肠外营养支持、控制感染、激素联合应用和其他手术治疗措施。结果42例患者中38例经过保守治疗均康复出院，4例保守治疗无效采用手术治疗后治疗痊愈出院。结论腹腔镜术后早期炎性肠梗阻产生原因可能是局部解剖不清楚、手术方式未及时更改等造成的，早期发现、全面评估，医生在手术中采取有效的保护措施和肠胃外营养支持以及抗感染、激素联合治疗等的应用可以预防腹腔镜肠梗阻的发生。

Objective To investigate causes and treatment measures of early postoperative inflammatory intestinal obstruction and improve the effectiveness of laparoscopic surgery. Methods 42 patients with early inflammatory intestinal obstruction after iaparoscopic surgery in our hospital were selected during January 2004 - June 2015, a retrospective analysis of early postoperative inflammatory intestinal obstruction in 42 patients mainly taken fasting , gastrointestinal decompression, fluid replacement to maintain water and electrolyte and acid-base balance, the early total parenteral nutrition support, infection control, and other surgical applications combined hormone treatment. Results 38 cases of 42 patients were discharged after conservative treatment, 4 cases treated by surgery after conservative treatment cured and discharged. Conclusion Laparoseopic early postoperative inflammatory intestinal obstruction may be the cause of the local anatomy is unclear, operation mode is not caused by the change in time, early detection, comprehensive assessment, doctors take effective protection measures and parenteral nutritional support in surgery and application of anti-infection, combined hormone therapy can prevent the occurrence of laparoscopic intestinal obstruction.