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高压氧疗法作为预防和治疗术后早期肠梗阻及复发性肠梗阻以缓解粘连性肠梗阻的手段。

Hyperbaric oxygen therapy as a prophylactic and treatment against ileus and recurrent intestinal obstruction soon after surgery to relieve adhesive intestinal obstruction.

作者信息

Ambiru Satoshi, Furuyama Nobuaki, Kimura Fumio, Shimizu Hiroaki, Yoshidome Hiroyuki, Miyazaki Masaru, Shimada Hideaki, Ochiai Takenori

机构信息

Departments of General Surgery, Surgical Center, Chiba University Hospital, Chiba University Graduate School of Medicine, Chiba, Japan.

出版信息

J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 2):e379-83. doi: 10.1111/j.1440-1746.2007.05023.x. Epub 2007 Jun 25.

DOI:10.1111/j.1440-1746.2007.05023.x
PMID:17593223
Abstract

BACKGROUND AND AIM

Nonoperative management of cases of adhesive intestinal obstruction would be ideal, especially for patients who have recently undergone surgery to relieve the same condition. We aimed to examine whether hyperbaric oxygen (HBO) therapy might have therapeutic potential for the treatment of postoperative paralytic ileus and recurrent adhesive intestinal obstruction soon after surgery, to relieve adhesive intestinal obstruction, because of its unique mechanisms in these contexts.

METHODS

A total of 133 patients were enrolled in the present study. We examined non-per os periods, hospital stay, and clinical course according to the postoperative course of the 133 patients.

RESULTS

After surgical intervention, 75 patients left the hospital without morbidity. Nineteen patients were successfully administered prophylactic HBO therapy to facilitate intestinal motility and to prevent paralytic ileus. The remaining 39 patients suffered from postoperative paralytic ileus or early recurrence of obstruction during the same hospitalization period. The patients who underwent prophylactic HBO therapy had significantly shorter non-per os periods and hospital stays after surgery than those who were not initially given HBO therapy (P < 0.05). Similarly, there were significant differences in duration of hospital stay after surgery between patients with HBO therapy as treatment and those who received other conservative therapies (P < 0.05).

CONCLUSIONS

HBO therapy may have a prophylactic effect on postoperative paralytic ileus and may be of therapeutic benefit in the management of early recurrent adhesive intestinal obstruction following surgery to relieve adhesive intestinal obstruction.

摘要

背景与目的

粘连性肠梗阻病例的非手术治疗是理想的,尤其是对于近期因同样病情接受过手术的患者。我们旨在研究高压氧(HBO)治疗对于术后麻痹性肠梗阻以及术后不久复发性粘连性肠梗阻是否具有治疗潜力,因其在这些情况下具有独特机制,有望缓解粘连性肠梗阻。

方法

本研究共纳入133例患者。我们根据这133例患者的术后病程,检查了禁食期、住院时间和临床过程。

结果

手术干预后,75例患者无并发症出院。19例患者成功接受了预防性HBO治疗,以促进肠道蠕动并预防麻痹性肠梗阻。其余39例患者在同一住院期间发生了术后麻痹性肠梗阻或早期梗阻复发。接受预防性HBO治疗的患者术后禁食期和住院时间明显短于未接受初始HBO治疗的患者(P<0.05)。同样,接受HBO治疗作为治疗手段的患者与接受其他保守治疗的患者术后住院时间也存在显著差异(P<0.05)。

结论

HBO治疗可能对术后麻痹性肠梗阻具有预防作用,并且在缓解粘连性肠梗阻手术后早期复发性粘连性肠梗阻方面可能具有治疗益处。

相似文献

1
Hyperbaric oxygen therapy as a prophylactic and treatment against ileus and recurrent intestinal obstruction soon after surgery to relieve adhesive intestinal obstruction.高压氧疗法作为预防和治疗术后早期肠梗阻及复发性肠梗阻以缓解粘连性肠梗阻的手段。
J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 2):e379-83. doi: 10.1111/j.1440-1746.2007.05023.x. Epub 2007 Jun 25.
2
Hyperbaric oxygen therapy for the treatment of postoperative paralytic ileus and adhesive intestinal obstruction associated with abdominal surgery: experience with 626 patients.高压氧疗法治疗腹部手术后的术后麻痹性肠梗阻和粘连性肠梗阻:626例患者的经验
Hepatogastroenterology. 2007 Oct-Nov;54(79):1925-9.
3
Effect of hyperbaric oxygen therapy on patients with adhesive intestinal obstruction associated with abdominal surgery who have failed to respond to more than 7 days of conservative treatment.高压氧疗法对腹部手术后粘连性肠梗阻且经超过7天保守治疗无效患者的影响。
Hepatogastroenterology. 2008 Mar-Apr;55(82-83):491-5.
4
Clinical effect of hyperbaric oxygen therapy in adhesive postoperative small bowel obstruction.高压氧治疗粘连性术后小肠梗阻的临床效果。
Br J Surg. 2014 Mar;101(4):433-7. doi: 10.1002/bjs.9389. Epub 2014 Feb 3.
5
Small bowel obstruction: conservative vs. surgical management.小肠梗阻:保守治疗与手术治疗
Dis Colon Rectum. 2005 Jun;48(6):1140-6. doi: 10.1007/s10350-004-0882-7.
6
[Adhesive small bowel occlusion: a clinical and therapeutic study of 163 consecutive patients].[粘连性小肠梗阻:163例连续患者的临床与治疗研究]
Chir Ital. 2007 Sep-Oct;59(5):651-9.
7
Does the index operation influence the course and outcome of adhesive intestinal obstruction?索引手术是否会影响粘连性肠梗阻的病程及预后?
Eur J Surg. 1997 Oct;163(10):767-72.
8
[Paralytic and postoperative ileus (author's transl)].[麻痹性肠梗阻与术后肠梗阻(作者译)]
MMW Munch Med Wochenschr. 1976 Feb 20;118(8):213-6.
9
[Complex intensive therapy of postoperative paralytic ileus in obstetrical and gynecological patients].
Anesteziol Reanimatol. 1985 Jan-Feb(1):38-41.
10
The clinical significance of adhesions: focus on intestinal obstruction.粘连的临床意义:聚焦于肠梗阻
Eur J Surg Suppl. 1997(577):5-9.

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