术后早期肠梗阻的诊断和治疗

The Diagnosis and Treatment of Early Postoperative Bowel Obstruction

目的 :探讨术后早期肠梗阻的特点、诊断和治疗方法 ,提高对本病的认识。方法 :分析近 2年来经治的 38例术后早期肠梗阻。结果 :32例经保守治疗治愈 ,平均治愈时间为 16 .5d。 6例经手术治愈 ,平均治愈时间为 19d ,无肠坏死。结论 :术后早期肠梗阻的特点①近期有腹部手术史 ,多于术后 3～ 8d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少数病例由于内疝、肠扭转、肠套叠、吻合口狭窄等机械性因素造成梗阻 ,多需手术解除梗阻。

Objective: To investigate the trait diagnosis and treatment of early postoperative bowel obstruction. Improve the knowledge of the disease. Methods: The 38 cases of early bowel obstruction were analysed retrospectived. Results: The 32 cases were cured in the mean period of 16.5 days through non-operative treatment and the others were cured in the mean period of 19 days with no intestine necrosis and resection. Conclusion: The traits of early postoperative bowel obstruction. (1)The cases of abdominal operation were occurring in early stage usually three to eight days postoperatively. (2)Mostly caused by extensive inflammations in abdomen and cured by non-operative but rare intestinal ischemia.Abdominal distension more prominent than abdominal pain. (3)A few of cases caused by mechanical factors(eg:entocele, volvulus, intussusception, stricture of anastomotic and so on)must be cured by operation.