Mora López Laura, Serra-Aracil Xavier, Llaquet Bayo Heura, Navarro Soto Salvador
Servicio de Cirugía General y del Aparato Digestivo, Corporació Sanitària i Universitària Parc Taulí, Sabadell, Barcelona, España.
Cir Esp. 2013 Jun-Jul;91(6):384-8. doi: 10.1016/j.ciresp.2012.10.011. Epub 2013 Mar 8.
Adhesions are the most important cause of intestinal obstruction. Approximately 25% of surgical admissions for acute abdominal conditions are due to intestinal obstruction. Better diagnostic and treatment methods of intestinal obstruction could potentially reduce mortality rate to 5-10%. Gastrografin(®) could contribute to this achieve this.
To present a protocol to treat adhesion intestinal obstruction with Gastrografin(®) that is safe, and allows shorter hospital stays and shorter time between admission and surgery.
All patients with adhesion intestinal obstruction without symptoms of strangulation were treated with Gastrografin(®), intravenous fluids and nasogastric tube. Those in whom contrast reach the colon in 8, 12 or 24hours were considered to have partial obstruction, and were fed orally. If Gastrografin(®) failed in the following 24hours, a laparotomy was performed.
Out of a total of 211 episodes (164 patients), 170 episodes received contrast and in 142 cases Gastrografin(®) reached the colon (104 episodes at 8h, 11 at 12h, and 27 at 24h). A laparotomy was required in 28 patients because of failed treatment, and in another 5 for other causes.
A management protocol for adhesion intestinal obstruction with Gastrografin(®) is safe, reduces morbidity and mortality, and leads to a shorter hospital stay.
粘连是肠梗阻最重要的病因。急性腹部疾病的外科住院患者中约25%是由肠梗阻引起的。更好的肠梗阻诊断和治疗方法有可能将死亡率降至5% - 10%。泛影葡胺（®）有助于实现这一目标。
提出一种使用泛影葡胺（®）治疗粘连性肠梗阻的方案，该方案安全，可缩短住院时间以及入院至手术的间隔时间。
所有无绞窄症状的粘连性肠梗阻患者均接受泛影葡胺（®）、静脉输液和鼻胃管治疗。造影剂在8、12或24小时内到达结肠的患者被认为是部分梗阻，给予口服喂养。如果泛影葡胺（®）在接下来的24小时内治疗失败，则进行剖腹手术。
在总共211例发作（164例患者）中，170例接受了造影剂检查，142例中泛影葡胺（®）到达结肠（8小时时104例，12小时时11例，24小时时27例）。28例患者因治疗失败需要进行剖腹手术，另外5例因其他原因进行手术。
使用泛影葡胺（®）治疗粘连性肠梗阻的管理方案是安全的，可降低发病率和死亡率，并缩短住院时间。
