Ambiru Satoshi, Furuyama Nobuaki, Aono Mitsuo, Kimura Fumio, Shimizu Hiroaki, Yoshidome Hiroyuki, Miyazaki Masaru, Shimada Hideaki, Ochiai Takenori
Surgical Center, Chiba University Hospital, Chuo-ku, Chiba 260-8677, Japan.
Hepatogastroenterology. 2007 Oct-Nov;54(79):1925-9.
BACKGROUND/AIMS: The results of hyperbaric oxygen (HBO) therapy for treatment of postoperative paralytic ileus and adhesive intestinal obstruction associated with abdominal surgery are unknown.
A retrospective review of postoperative paralytic ileus and adhesive intestinal obstruction associated with abdominal surgery in 626 patients required 758 admissions who underwent HBO therapy was undertaken to examine the efficacy of HBO therapy.
The overall resolution rates for patients receiving HBO therapy in cases of postoperative paralytic ileus and adhesive intestinal obstruction were 92% and 85%, respectively. Among patients who were more than 75 years old, the therapies resolved 35 (97%) of 36 cases of postoperative paralytic ileus and 42 (81%) of 52 cases of adhesive intestinal obstruction, which was comparable to the results for patients less than 75 years old. The mortality rate was 1.2% overall. Complications related to HBO therapy occurred in 3.8% of the admissions, and most of them were not serious.
These results suggest that HBO therapy might deserve further assessment for use in management of postoperative paralytic ileus and adhesive intestinal obstruction as a new modality. HBO therapy is safe and non-invasive, and may be useful in the elderly patients, since mortality was relatively low in this series.
背景/目的:高压氧(HBO)疗法用于治疗腹部手术后的麻痹性肠梗阻和粘连性肠梗阻的效果尚不清楚。
对626例因腹部手术导致麻痹性肠梗阻和粘连性肠梗阻而接受HBO治疗的患者进行回顾性研究,共758次入院,以检验HBO疗法的疗效。
接受HBO治疗的患者中,术后麻痹性肠梗阻和粘连性肠梗阻的总体缓解率分别为92%和85%。在75岁以上的患者中,该疗法使36例术后麻痹性肠梗阻中的35例(97%)和52例粘连性肠梗阻中的42例(81%)得到缓解,这与75岁以下患者的结果相当。总体死亡率为1.2%。与HBO治疗相关的并发症发生在3.8%的入院病例中,且大多数并不严重。
这些结果表明,HBO疗法作为一种新的治疗方式,在术后麻痹性肠梗阻和粘连性肠梗阻的管理中可能值得进一步评估。HBO疗法安全且无创,在老年患者中可能有用,因为本系列研究中的死亡率相对较低。