Mertens R, Ocqueteau M, Guzmán S, Rahmer A, Llanos O, Ibáñez L, Zúñiga A
Servicio de Cirugía, Hospital Clínico de la Pontificia Universidad Católica, Santiago, Chile.
Rev Med Chil. 1990 Oct;118(10):1085-9.
Adhesions are the most common cause of intestinal obstruction. Medical treatment for those patients with no signs of vascular involvement has been successful in many cases. We reviewed the clinical records of 87 patients with intestinal obstruction due to adhesions, having a total of 122 episodes. Satisfactory follow up was obtained in 76% of patients for a mean of 29.6 months. 47% of episodes resolved without need for surgical intervention. Volume entrapment during the first hours was correlated with need for surgical treatment (p < 0.01). Recurrences were not different between medical and surgical patients (p = 0.28). Thus, medical treatment of this type of intestinal obstruction may be attempted in most patients, not only those who are poor surgical risks.
粘连是肠梗阻最常见的病因。对于那些没有血管受累迹象的患者,药物治疗在许多情况下都取得了成功。我们回顾了87例因粘连导致肠梗阻患者的临床记录,共有122次发作。76%的患者获得了满意的随访,平均随访时间为29.6个月。47%的发作无需手术干预即可缓解。最初几小时内的肠内容物潴留与手术治疗的需求相关(p<0.01)。药物治疗和手术治疗的患者复发情况无差异(p=0.28)。因此,大多数这类肠梗阻患者都可以尝试药物治疗,而不仅仅是手术风险高的患者。