术后早期炎性肠梗阻的诊疗分析(附27例报告)

Diagnosis and treatment of early postoperative inflammatory intestinal obstruction-report of 27 cases

目的 :探讨术后早期炎性肠梗阻的临床特点及治疗措施。方法 :回顾分析 2 7例术后早期炎性肠梗阻患者的临床资料。结果 :2 7例中 ,19例经胃肠减压、营养支持、广谱抗生素、生长抑素和肾上腺糖皮质激素的应用等综合措施治愈 ,治愈时间平均为 16 5天。手术治疗 8例 ,2例术后发生肠瘘 ,2例因败血症和多器官功能衰竭死亡。结论 :术后早期炎性肠梗阻多发生在术后 1～ 3周。非手术治疗是治疗的首选 ,其疗效良好。手术治疗困难且易发生术后并发症。

Objective:To investigate the clinical features and principle of treatment of early postoperative inflammatory intestinal obstruction (EPIIO).Methods:Clinical data of 27 cases of EPIIO admitted in our hospital in recent 8 years were analysed retrospectively.Results:19 patients among 27 cases were treated by non-operative modalities,including fasting and gastrointestinal decompression,parenteral nutrition support,and administration of broad-spectrum antibioctics,glucocorticoid and somatostatin.All the 19 cases were cured and the average time of cure was 16.5 days.8 among 27 cases underwent surgical treatment.2 among these cases developed intestinal fistula postoperatively,and 2 cases died for septicemia or multiple organic functional failure.Conclusion:EPIIO mainly occurs in about 1～3 weeks postoperatively.Non-operative treatments should be the first choice which is very effective for this disease.Surgical treatment is difficult which often develops morbiditis postoperatively.