早期鼻饲泛影葡胺对粘连性肠梗阻诊治价值的临床研究  

Study on early naso feeding urografin for the diagosis and treatment of adhesive intestinal obstruction

作　　者：章琳[1] 徐财文 麦达昌[1] 杨云江[1] 孙海光[1] 乐敬 张周义 刘华仁[1] 麦卫国 周军[2] 

机构地区：[1]东莞市长安医院普外科,523843 [2]中山大学附属第二医院胃肠外科,510120

出　　处：《岭南现代临床外科》2008年第2期96-98,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨早期鼻饲泛影葡胺对粘连性肠梗阻的诊断及治疗效果。方法对95例临床及X线检查确诊之粘连性肠梗阻患者被为分研究组与对照组。48例经胃管注入76%复方泛影葡胺80ml为研究组,同时设无需胃管注入造影剂为空白对照组47例进行比较。结果研究组中40例造影剂在6～24h内到达结肠而给予保守治疗,平均症状缓解时间为16±2.5h,1～5d(平均2.8d)后症状消失;另8例见造影剂未进入结肠且症状体征加重选择及时剖腹手术治疗。对照组手术治疗16例,7例出现绞窄性肠梗阻。中转手术率及绞窄性肠梗阻发生率两组比较(16.67%vs34.04%;2.08%vs14.89%)均有显著性差异(P<0.05)。结论复方泛影葡胺应用于胃肠道造影对明确粘连性肠梗阻的梗阻部位及合理选择手术时机有很好的指导作用,早期鼻饲泛影葡胺有助于肠梗阻的缓解。Objective To investigate the diagnosis and therapeutic value of early nosefeeding urografin for adhesive intestinal obstruction. Methods From May 2004 to April 2007,95 cases with adhesive intestinal obstruction were confirmed by clinical and X ray examination. These patients were divided into study group and control group. 48 cases were served as study group, which use of 76% compound urografin 80 ml were injected through stomach tube. No contrast medium was injected as control group in 47 eases. Results In the study group, when the contrast medium was reached to the colon within 6～24 hours, the conservative treatment was performed in 40 cases. The average symptomatic remission time was 16±2.5 hours and symptoms were disappeared after 1 to 5-day injected contrast medium. In the other 8 cases, no contrast medium entering into the colon and aggrevation of symptoms and signs in time laparomy was selected. In tile control group 16 cases underwent operative treatment and strangulated intestinal obstruction was found in 7 cases. Incidence of transferred to operation and strangulated intestinal obstruction had significamt difference between two groups （16.67% vs 34.04%, 2.08% vs 14,89%,P〈0.05）. Conclusion Compound urografin applied to gastro-intestinal series can get a direct role for confirming obstructive position and on selecting operative timing. Early naso-feeding urografin may contribute to remission of adhesive intestinal obstruction.

关 键 词：泛影葡胺 粘连性肠梗阻 

分 类 号：R656.7[医药卫生—外科学]