Rahmani Nasrin, Mohammadpour Reza Ali, Khoshnood Peyman, Ahmadi Amirhossein, Assadpour Sara
Department of Surgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Biostatics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.
Indian J Surg. 2013 Jun;75(3):195-9. doi: 10.1007/s12262-012-0479-7. Epub 2012 Apr 13.
Oral Gastrografin®, a hyperosmolar water-soluble contrast medium, may have a therapeutic effect in adhesive small bowel obstruction. However, findings are still conflicting, as some authors did not find a therapeutic advantage. So, this prospective, randomized, and clinical trial study was designed to determine the value of Gastrografin in adhesive small bowel obstruction. The primary end points were the evaluation of the operative rate reduction and shortening the hospital stay after the use of Gastrografin. A total of 84 patients were randomized into two groups: the control group received conventional treatment, whereas the study group received in addition of 100 mL Gastrografin meal. Patients were followed up within 4 days after admission, and clinical and radiological (if needed) improvements were evaluated. Although the results showed that Gastrografin can decrease the need for surgical management by 14.5 %, no statistically significant differences were observed between the two groups (P = 0.07). Nevertheless, the length of hospital stay revealed a significant reduction from 4.67 ± 1.18 days to 2.69 ± 1.02 days (P = 0.00). The use of Gastrografin in adhesive small bowel obstruction is safe and reduces the length of hospital stay. As a result, the cost of hospital bed occupancy is reduced. Hence, if there was no indication of emergency surgery, administration of oral Gastrografin as a nonoperative treatment in adhesive small bowel obstruction is also recommended.
口服泛影葡胺（Oral Gastrografin®）是一种高渗性水溶性造影剂，对粘连性小肠梗阻可能具有治疗作用。然而，研究结果仍存在矛盾，因为一些作者未发现其治疗优势。因此，本前瞻性、随机临床试验研究旨在确定泛影葡胺在粘连性小肠梗阻中的价值。主要终点是评估使用泛影葡胺后手术率的降低和住院时间的缩短。总共84例患者被随机分为两组：对照组接受常规治疗，而研究组除常规治疗外还接受100毫升泛影葡胺餐。患者在入院后4天内接受随访，并评估临床和影像学（如有需要）改善情况。尽管结果显示泛影葡胺可使手术治疗需求降低14.5%，但两组之间未观察到统计学上的显著差异（P = 0.07）。然而，住院时间从4.67±1.18天显著缩短至2.69±1.02天（P = 0.00）。在粘连性小肠梗阻中使用泛影葡胺是安全的，并可缩短住院时间。因此，可降低病床占用成本。因此，如果没有急诊手术指征，也建议将口服泛影葡胺作为粘连性小肠梗阻的非手术治疗方法。
