Li Wei, Li Zhixia, An Dali, Liu Jing, Zhang Xiaohu
Department of General Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Mar;17(3):275-8.
To evaluate the role of the small intestinal decompression tube (SIDT) and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO).
Twelve patients presented EPISBO after abdominal surgery in our department from April 2011 to July 2012. Initially, nasogastric tube decompression and other conventional conservative treatment were administrated. After 14 days, obstruction symptom improvement was not obvious, then the SIDT was used. At the same time, Gastrografin was injected into the small bowel through the SIDT in order to demonstrate the site of obstruction of small bowel and its efficacy.
In 11 patients after this management, obstruction symptoms disappeared, bowel function recovered within 3 weeks, and oral feeding occurred gradually. Another patient did not pass flatus after 4 weeks and was reoperated. After postoperative follow-up of 6 months, no case relapsed with intestinal obstruction.
For severe and long course of early postoperative inflammatory intestinal obstruction, intestinal decompression tube plus Gastrografin is safe and effective, and can avoid unnecessary reoperation.
评估小肠减压管(SIDT)和泛影葡胺在术后早期炎性小肠梗阻(EPISBO)治疗中的作用。
2011年4月至2012年7月,我科12例患者腹部手术后出现EPISBO。起初,给予鼻胃管减压及其他常规保守治疗。14天后,梗阻症状改善不明显,则使用SIDT。同时,通过SIDT向小肠内注入泛影葡胺,以显示小肠梗阻部位及其疗效。
采用此治疗方法后,11例患者梗阻症状消失,肠功能在3周内恢复,逐渐恢复经口进食。另一例患者4周后仍未排气,再次手术。术后随访6个月,无病例复发肠梗阻。
对于术后早期炎性肠梗阻病情严重、病程较长者,肠减压管联合泛影葡胺安全有效,可避免不必要的再次手术。