摘要
术后早期炎症性肠梗阻多因腹部手术创伤及腹腔内无菌性炎症等原因引起的肠壁水肿及渗出,形成的动力性和机械性并存的粘连性肠梗阻。诊断标准:(1)腹部术后2周内发生肠梗阻;(2)术后肠功能短暂恢复,进食水后再出现肠梗阻,以腹胀为主;(3)腹部X线平片和全腹CT多个小的液气平面,无高度扩张的肠管。治疗理念:(1)禁食水+胃肠减压+维持水电解质平衡;(2)以完全肠外营养支持;(3)生长抑素应用减少肠腔内积液,减轻肠壁水肿;(4)肾上腺皮质激素应用;(5)胃肠动力药可促进肠道功能恢复;(6)在治疗过程中,若体温持续上升、腹痛腹胀进行性加剧、出现腹膜炎征象时,应及时中转手术治疗。
Inflammatory ileus is defined as a complicated adhesive intestinal obstruction,involving dynamic and mechanical factors because of edema and effusion caused by abdominal surgical trauma and aseptic inflammation.Diagnostic criteria of inflammatory ileus in early postoperative period include：1.Ileus occurring within 2 weeks post operation;2.Postoperative temporal recovery of intestinal function followed by secondary obstruction with major symptoms of abdominal distention;3.Excluding symptoms of strangulating intestinal obstruction and exhibiting several liquid-gas planes on X-ray and CT without signs of significantly expanded intestine.Treatment principles include：1.Fasting diet,gastrointestinal decompression and keeping water-electrolyte balance;2.Giving complete parenteral alimentation;3.Using somatostatin to inhibit the overall secretion of gastric,intestinal,pancreatic and bile fluid so as to decrease the fluidity within the enteric cavity and to palliate intestinal edema and to improve bowel function.4.Using adrenal cortex hormone to prevent inflammatory effect;5.Using domperidone to improve bowel function;6.Once there are physical signs of peritonitis such as rising of body temperature and aggravation of abdominal pain and distention,surgical intervention should be given in time.
出处
《中华普外科手术学杂志（电子版）》
2011年第3期10-12,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
肠梗阻
炎症
手术后期间
诊断
治疗学
Intestinal obstruction
Inflammation
Postoperative period
Diagnosis
Therapeutics
