Mughal M M, Irving M H
Hope Hospital, University of Manchester School of Medicine, Salford.
Gut. 1988 Nov;29(11):1613-7. doi: 10.1136/gut.29.11.1613.
Three cases are described of end stage chronic intestinal pseudo-obstruction successfully treated by subtotal enterectomy and home parenteral nutrition (HPN). In all three patients prior use of drugs to stimulate gastrointestinal motility, antibiotics to suppress bacterial overgrowth and surgical bypass of dilated bowel had failed to alleviate the symptoms of chronic intestinal obstruction. Similarly parenteral nutrition combined with restriction of oral intake, although improving nutrition did not relieve symptoms. The treatment of end stage chronic pseudo-obstruction should relieve intestinal obstruction and correct nutritional deficiency. In our experience this is best achieved by subtotal enterectomy, restoration of continuity by end-to-end anastomosis and total parenteral nutrition.
本文描述了3例终末期慢性肠梗阻患者，通过小肠次全切除术和家庭肠外营养（HPN）成功治愈。在所有3例患者中，先前使用刺激胃肠蠕动的药物、抑制细菌过度生长的抗生素以及对扩张肠段进行手术旁路均未能缓解慢性肠梗阻的症状。同样，肠外营养联合限制口服摄入量，虽然改善了营养状况，但并未缓解症状。终末期慢性假性肠梗阻的治疗应缓解肠梗阻并纠正营养缺乏。根据我们的经验，小肠次全切除术、端端吻合恢复肠道连续性以及全肠外营养能最好地实现这一目标。
