中西医结合治疗急性肠梗阻85例临床观察

Combine Traditional Chinese and Western Medicine Treatment of Acute Intestinal Obstruction,85 Cases of Clinical Observation

[目的]观察中西医结合治疗急性肠梗阻疗效。[方法]使用随机平行对照方法,将85例住院及门诊患者胃肠减压,抗生素头孢噻肟纳4g+0.9%生理盐水200mlq12h/d,静滴,保证水电解质平衡。胃肠减压2～3h后,经胃管注入中药,防止呕吐或减少呕吐,发挥中药效力。辨证治疗:实热,寒实,肠燥津枯。颠簸:取俯伏膝肘位,加大肘膝关节间距离,充分暴露下腹部。术者在患者一侧用双手在患者腹部两侧上下或左右震荡,震度由小渐次扩大,以能忍受为度。5～10min/次,根据情况可反复应用。按摩:取仰卧位,术者以双手轻而有力顺扭转相反方向按摩,同时多次改变体位,以助膨胀肠袢之回旋复位,按摩时以舒适为宜。若为蛔虫性肠梗阻,以轻揉手法将蛔虫团块揉散。电针:取足三里、上巨虚、内关、天枢、中脘穴,强刺激电疗30～60min,2次/d,止痛、止呕和肠梗阻。灌肠:经胃管注入2%温盐水400～800mL,或用复方大承气汤,200～300mL点滴保留灌肠,辅助治疗,利于排气、排便、解除梗阻症状。连续治疗7d为1疗程。观测临床症状、不良反应。连续治疗1疗程,判定疗效。[结果]治愈:40例。好转25例,无效22例(中转手术20例,死亡2例),总有效率76.40%。[结论]中西医结合治疗急性肠梗阻效果显著,值得推广。

[Objective]To observe the curative effect in treatment of acute intestinal obstruction which combines traditional Chinese medicine with western medicine.[Methods]Using random parallel control method,85 cases of inpatient and outpatient patients with gastrointestinal decompression,antibiotics,cefotaxime sodium 4g plus 0.9% saline mlq12h/200 d,static drops,assure water and electrolyte balance.Gastrointestinal decompression after 2～3 h,the stomach tube injection of traditional Chinese medicine(TCM),to prevent vomiting or reduce vomiting,play traditional Chinese medicine(TCM).Syndrome differentiation treatment:hot,cold,intestinal dry dry,tianjin.Elbow bump:take down knee more elbow knee joint,the distance between fully exposed lower abdomen.Performer at the side of the patients with both hands around on both sides of the upper and lower abdomen or shock,degree gradually expanded,from small to endure.5 ～ 10 min/time,according to the situation can be repeatedly used.Massage:apply the supine position,use the performer with hands light and strong massage along turn in the opposite direction,many times change posture at the same time,to help expand the bowel loops of cyclotron reset,with a comfortable massage is advisable.For the worm ileus to rub gimmick to get worm mass.Acusector:take on foot three mile,giant virtual pivot,the clearance,day,often in the hole,strongly stimulated electrotherapy 30～60 min,2 times/d,analgesic,antinausea and intestinal obstruction.Salt water enema:the stomach tube injection of 2% from 400 to 800 ml,or with large compound bearing gas soup,200 ～ 300 ml intravenous drip retention enema,adjuvant therapy,exhaust and defecate,remove obstruction symptoms.Continuous treatment of 7 d for 1 course of treatment.Observation of clinical symptoms and adverse reactions.Continuous treatment 1 treatment course,judge curative effect.[Results]To cure:40 cases.Improvement in 25 cases,22 cases(20 cases of the operation,2 cases died),the total effective rate was 76.40%.[Conclusion]The combination of Chinese and western medicine treatment of acute intestinal obstruction effect is remarkable,is worth promoting.