腹部手术后早期炎性肠梗阻的诊治分析

摘要

Objective To discusses the clinical features of early inflammatory bowel obstruction (EPIS-BO) after abdominal surgery,and analyze diagnosis and treatment. Methods The clinical data of 48 patients with early inflammatory bowel obstruction after abdominal surgery were analyzed retrospectively from July 2005 to July 2015. Results 45 patients were recovered after non-operative treatment including gastrointestinal decompression , total parenteral nutrition (TPN),antibiotics,glucocorticoid and somatostatin. The average time of treatment was 17.45 days. The other 3 patients underwent laparotomy respectively on 16,19 and 20 days after conservative treat-ment.Two cases were turned to intestinal fistula after operation ,and one of them died after reoperation because of severe abdominal infection 9 days later. Conclusion Conservative treatment should be regarded as the first choice for EPISBO in clinical practice due to less complications and better effect than operative treatment.%目的 探讨腹部手术后早期炎性肠梗阻的临床特点,以及诊断和治疗分析.方法 回顾性分析2005年7月至2015年7月收治的48例腹部外科手术后早期炎性肠梗阻患者的临床资料.结果 45例患者经胃肠减压,全胃肠外营养支持,应用肾上腺皮质激素、生长抑素和抗生素等非手术治疗痊愈,平均治疗时间为17.45 d.另3例患者分别于术后16、19、20 d保守治疗无效中转手术治疗,2例于术后出现肠瘘,其中1例患者于术后第9天死于严重腹腔感染.结论 术后早期炎性肠梗阻应首选非手术治疗.手术治疗并发症多,疗效差.