Schwemmle K
MMW Munch Med Wochenschr. 1976 Feb 20;118(8):213-6.
Paralytic ileus is always a reaction of the organism to a disturbance usually due to metabolism. A treatment without elimination of the eliciting cause seems, therefore, to have little point. The efficacy of many substances given to stimulate peristalsis has not been proved. Drawing off the contents of the stomach and controlled infusion therapy, on the other hand, are important parts of the treatment, as for mechanical ileus. For the surgical emptying of the intestine, the most suitable procedure is retrograde squeezing of the intestinal contents to the stomach and aspiration through a nasal sound. Enterotomies should be avoided if at all possible. Surgical intervention for paralytic ileus is most frequently necessary in the postoperative phase, usually caused by a peritonitis with or without anastomotic failure. Differentiation from mechanical obstruction is not always possible. In the Erlangen Hospital, 233 patients were treated for postoperative ileus from 1965 to 1974. All patients with a mechanical ileus were operated on, the mortality was 17%. Of 123 patients with a paralytic ileus, 82 were operated on and 45 died. The mortality was almost equally high in patients not operated on.
麻痹性肠梗阻始终是机体对通常因代谢紊乱而产生的一种反应。因此，不消除引发原因的治疗似乎毫无意义。许多用于刺激肠蠕动的物质的疗效尚未得到证实。另一方面，像治疗机械性肠梗阻一样，抽出胃内容物和进行控制输注疗法是治疗的重要组成部分。对于肠道的手术排空，最合适的方法是将肠内容物逆行挤压至胃内，并通过鼻饲管抽吸。应尽可能避免进行肠切开术。麻痹性肠梗阻的手术干预在术后阶段最为常见，通常由伴有或不伴有吻合口失败的腹膜炎引起。与机械性梗阻的鉴别并不总是可行的。在埃尔朗根医院，1965年至1974年期间有233例患者接受了术后肠梗阻的治疗。所有机械性肠梗阻患者均接受了手术，死亡率为17%。在123例麻痹性肠梗阻患者中，82例接受了手术，45例死亡。未接受手术的患者死亡率几乎同样高。
