论文部分内容阅读
目的探讨大肠癌术后早期炎性肠梗阻的发病原因、临床特点和治疗措施。方法回顾性分析2000～2005年28例大肠癌术后早期炎性肠梗阻的临床特点和治疗方法。结果28例术后早期炎性肠梗阻经禁食、胃肠减压、全肠外营养支持、抗生素以及配合复方大承气汤保留灌肠等疗法,痊愈26例,中转手术2例。平均发生时间是术后8.9d,平均治愈时间13.2d。结论大肠癌术后早期炎性肠梗阻多发生在术后1周左右,临床上有典型的肠梗阻症状和体征,但以腹胀和肛门停止排气排便为主,腹痛和呕吐相对较轻。可能的发病原因是手术创伤、腹腔内炎症、积液积血或异物刺激导致术后小肠出现炎性水肿,浆膜表面渗出增加,产生一系列免疫反应,造成腹膜间粘连而成,采用禁食、胃肠减压、抗炎、营养支持、中药灌肠或手术等疗法,效果良好。
Objective To investigate the cause, clinical features and treatment of early inflammatory bowel obstruction after colorectal cancer. Methods The clinical features and treatment of early postoperative inflammatory bowel obstruction in 28 patients with colorectal cancer from 2000 to 2005 were analyzed retrospectively. [Results] 28 cases of early postoperative inflammatory bowel obstruction were treated with fasting, gastrointestinal decompression, total parenteral nutrition, antibiotics, and compound Dacheng Qi Tang retention enema. 26 cases were cured and 2 cases were transferred. The average time of occurrence was 8.9 days after surgery and the average healing time was 13.2 days. Conclusions Early postoperative inflammatory bowel obstruction in colorectal cancer occurs mostly around 1 week after operation. Clinical symptoms and signs of intestinal obstruction are typical in clinic. However, abdominal bloating and anal stop and exhaust defecation are the main reasons. Abdominal pain and vomiting are relatively light. Possible causes are surgical trauma, intra-abdominal inflammation, effusion, or foreign body irritations leading to postoperative inflammatory edema in the small intestine, increased serosal surface exudate, and a series of immune reactions that cause peritoneal adhesions. Food, gastro-intestinal decompression, anti-inflammatory, nutritional support, Chinese medicine enema, or surgery, etc., have good results.