23例术后早期炎性肠梗阻临床诊治体会

摘要

目的：探讨术后早期炎性肠梗阻的临床特点，总结有效的治疗方法，为临床上术后早期炎性肠梗阻的早期诊断和治疗提供依据。方法以江西省萍乡市第二人民医院2002年10月～2013年3月接收的23例术后早期炎性肠梗阻患者为研究对象，对其临床资料进行回顾性分析。结果术后早期炎性肠梗阻一般在腹部手术后3～19d出现，以腹痛、腹胀、肛门停止排气为主要特征，B超和CT检查结合可以确诊。23例患者经保守治疗后全部恢复正常饮食，均达到治愈标准。随访3～6个月，无1例出现复发。肠梗阻症状于3～7 d开始逐渐缓解；治疗9～20 d症状消退；平均(12.7±1.4) d；第3天开始排气、排便的2例，4～7d的6例，7～10d的13例，10d以后排气排便的2例。结论术后早期炎性肠梗阻有典型的临床症状，并且B超、CT检查等可以对其进行早期诊断；一旦明确诊断，行保守治疗能够明显改善症状，避免不必要的二次手术损伤，临床疗效好。%Objective To investigate clinical features of early postoperative inlfammatory small bowel obstruction(EPISBO), and summarize effective treatments for providing experience for the diagnosis and treatment of early postoperative inlfammatory small bowel obstruction.Methods The clinical data of 95 patients that had early postoperative inlfammatory small bowel obstruction and from October 2012 to April 2013 in our hospital were retrospectively analyzed.Results Intestinal obstruction occurred within 3-19 days after operation in all the 23 cases, and the main characteristics of early postoperative inlfammatory small bowel obstruction were abdominal pain and distension, stop anus exhaust ,and could be conifrmed by B ultrasound CT examination. 23 patients all returned to normal diet and reached the standard cure, and had no recurrence for following-up with 3-6 months. The symptoms of intestinal obstruction began to relieve in 3 to 7 days; 9-20 days subsided, and the average time was (12.7±1.4) days. of patients that exhausted and defecated in the third day was 2 cases, 4-7 days was 6 cases, 7-10 days was 13 cases, and 2 cases exhausted and defecated after 10 days.Conclusion Early postoperative inlfammatory small bowel obstruction has the typical clinical symptoms, and can be early diagnosed by B ultrasound CT examination. Conservative treatment can signiifcantly improve the clinical symptoms, and avoid unnecessary injury of secondary surgery, and the clinical effect is good..