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中华普外科手术学杂志(电子版) ›› 2021, Vol. 15 ›› Issue (01) : 101 -103. doi: 10.3877/cma.j.issn.1674-3946.2021.01.029

所属专题: 经典病例 文献

论著

四十例术后炎性肠梗阻诊疗分析
李合1,(), 周晓华1, 陈兴超1   
  1. 1. 570102 海南医学院第一附属医院普通外科
  • 收稿日期:2019-11-26 出版日期:2021-02-10
  • 通信作者: 李合

Clinical analysis of the diagnosis and treatment of early postoperative inflammatory intestinal obstruction, report of 40 cases

He Li1,(), Xiaohua Zhou1, Xingchao Chen1   

  1. 1. Department of General Surgery, The Affiliated Hospital of Hainan Medical college, Hainan 570102, China
  • Received:2019-11-26 Published:2021-02-10
  • Corresponding author: He Li
  • Supported by:
    Natural Science Foundation of Hainan Province(20158351)
引用本文:

李合, 周晓华, 陈兴超. 四十例术后炎性肠梗阻诊疗分析[J]. 中华普外科手术学杂志(电子版), 2021, 15(01): 101-103.

He Li, Xiaohua Zhou, Xingchao Chen. Clinical analysis of the diagnosis and treatment of early postoperative inflammatory intestinal obstruction, report of 40 cases[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(01): 101-103.

目的

对早期炎性肠梗的临床特点进行分析,探讨其诊断及治疗方法。

方法

回顾性分析2012年06月至2017年06月40例早期炎性肠梗阻患者临床资料,对其临床特点、诊断治疗方法和预后进行总结。

结果

38例患者于保守治疗后2周内症状消失,平均治愈时间(12.8±2.5) d。另外2例患者经保守治疗后无显著改善,进行再次手术治疗。

结论

对术后早期炎性肠梗阻患者应反复对其进行详细体格检查及必要相关检查,尽早做出诊断,以保守治疗为主,多可取得良好效果,对保守治疗无效、出现完全性或绞窄性肠梗阻及腹膜炎症状的患者应及时采取手术治疗。

Objective

To analyze the clinical features of early postoperative inflammatory intestinal obstruction, and to discuss its diagnosis and management protocol.

Methods

From June 2012 to June 2017, clinical data of 40 cases of early inflammatory intestinal obstruction were analyzed retrospectively. Their clinical features, protocols of diagnosis and management, and prognosis were summarized.

Results

38 cases were cured within 2 weeks by conservative treatment, with an average of (12.8±2.5 ) days, while the other 2 cases without improvement by conservative treatment, then received re-operation.

Conclusions

Regular detailed physical examinations and associated diagnostic tools are mandatory for suspicious patients of early postoperative inflammatory intestinal obstruction. Prompt diagnosis and conservative therapy might achieve satisfactory results in most cases. Reoperation is needed for those who fail after conservative course and have symptoms of completely or strangulation intestinal obstruction or peritonitis.

[1]
Afzali A, Park CJ, Zhu K, et al. Preoperative Use of Methotrexate and the Risk of Early Postoperative Complications in Patients with Inflammatory Bowel Disease[J].Inflamm Bowel Dis, 2016, 22(8): 1887-1895.
[2]
Fink-Neuboeck N, Lindenmann J, Bajric S, et al. Clinical impact of interleukin 6 as a predictive biomarker in the early diagnosis of postoperative systemic inflammatory response syndrome after major thoracic surgery: A prospective clinicaltrial[J]. Surgery, 2016, 160(2): 443-453.
[3]
Smith SA, Roberts DJ, Lipson ME, et al. Postoperative Nonsteroidal Anti-inflammatory Drug Use and Intestinal Anastomotic Dehiscence: A Systematic Review and Meta-Analysis[J].Dis Colon Rectum,2016, 59(11): 1087-1097.
[4]
Suwa K, Ushigome T, Ohtsu M, et al. Risk Factors for Early Postoperative Small Bowel Obstruction After Anterior Resection for Rectal Cancer[J]. World J Surg, 2018, 42(1): 233-238.
[5]
黎介寿.认识术后早期炎性肠梗阻的特性[J].中国实用外科杂志,1998,18(7): 387-388.
[6]
Nakamura T, Sato T, Naito M, et al.Laparoscopic Surgery is Useful for Preventing Recurrence of Small Bowel Obstruction After Surgery for Postoperative Small Bowel Obstruction[J]. Surg Laparosc Endosc Percutan Tech, 2016, 26(1): e1-e4.
[7]
Aquina CT, Probst CP, Becerra AZ, et al.Missed Opportunity: Laparoscopic Colorectal Resection Is Associated With Lower Incidence of Small Bowel Obstruction Compared to an Open Approach[J]. Ann Surg,2016, 264(1): 127-134.
[8]
陆路,唐武,来伟,等.腹部手术后早期炎性肠梗阻的诊治分析[J].实用医学杂志,2017,33(15): 2511-2513.
[9]
翁剑锋,何建苗,赵华洲,等.176例肠结核严重并发症的外科手术治疗分析[J].中国防痨杂志,2018,40(11): 1183-1188.
[10]
Afzali A, Park CJ, Zhu K, et al. Preoperative Use of Methotrexate and the Risk of Early Postoperative Complications in Patients with Inflammatory Bowel Disease[J]. Inflamm Bowel Dis, 2016, 22(8): 1887-1895.
[11]
Chen QY, Feng XB, Ni L, et al. [Effects of perioperative intestinal microecological treatment on postoperative complications and gastrointestinal function in patients with refractory functional constipation][J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2017, 20(12): 1365-1369.
[12]
Guo MJ. Investigation into early postoperative inflammatory small bowel obstruction by applying gastrointestinal decompression[J]. J Biol Regul Homeost Agents, 2016,30(3): 811-814.
[13]
李祥,蒲羽,邱远,等.腺苷酸A2A受体对小鼠小肠急性缺血再灌注损伤中肠屏障功能的影响[J].第三军医大学学报,2017,39(10): 960-965.
[14]
Xia J, Xie W, Chen L, et al. Abdominal cocoon with early postoperative small bowel obstruction: A case report and review of literature in China[J]. Medicine, 2018, 97(25): e11102.
[15]
徐群,付宇,沃扣洪.腹腔镜下粘连性肠梗阻手术的时机选择[J].徐州医学院学报,2016, 36(3): 163-164.
[16]
Joseph SP, Simonson M, Edwards C.'Let's just wait one more day': impact of timing on surgical outcome in the treatment of adhesion-related small bowel obstruction[J].Am Surg,2013,79(2): 175-179.
[17]
王春辉.急性粘连性肠梗阻治疗中腹腔镜下松解术的应用分析[J].中国保健营养,2019,29(29): 37-38.
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