肠结核并发肠梗阻的外科治疗分析

Surgical treatment of enterophthisis complicated with intestinal obstruction

探讨肠结核并发肠梗阻的临床特点及疗效。对2010年7月-2015年7月天津中医药大学第一附属医院收治的15例肠结核并发肠梗阻患者的临床资料进行回顾性分析及要点总结。对15例患者保守治疗5例,手术治疗10例,保守治疗首选不完全性肠梗阻患者,均给予持续胃肠减压,联合使用抗结核药等对症治疗,10个月左右症状体征逐渐缓解治愈。手术治疗为急性完全性肠梗阻患者,在经过24h的保守治疗后,症状得不到缓解的情况下,进行了手术,所有患者术后继续抗结核治疗,10个月左右全部治愈。肠结核并发肠梗阻患者的病程长,早期及时给予持续胃肠减压,联合使用抗结核药,有较好的治疗效果,但对于需要手术的患者,应根据术中的病变情况来决定手术方式,方可保证治疗的效果,使患者早日康复。

To investigate the clinical characteristics and curative effect of enterophthisis complicated with intestinal obstruction. The clinical data of 15 cases of enterophthisis complicated with intestinal obstruction were retrospectively analyzed and summrized in First Hospital Affiliated to Tianjin Medical University from July 2010 to July 2015.5 patients of them were given conservative treatment, 10 cases were treated with surgical treatment. Conservative treatment preferred incomplete intestinal obstruction patients were given continuous gastrointestinal decompression and used anti tuberculosis drugs etc. The signs and symptoms remittence were gradual and disappeared in 10 months. Patients with acute complete obstruction, whose symptoms didn＇t improve after 24h conservative treatment, were treat with surgical treatment. And the patients were given anti tuberculosis treatment after operation. They were cured around 10 months. Patients with enterophthisis complicated with intestinal obstruction need long duration of treatment. Early and timely given continuous gastrointestinal decompression and combined use anti tuberculosis drugs can get a better therapeutic effect. But for patients who need operation, operation method should be decided according to the intraoperative pathological condition for better effect.