肠梗阻的急诊处理临床疗效观察  

Clinical Curative Effect Observation about Emergency Treatment of Intestinal Obstruction

作　　者：许杰[1] 许三林[1] 严松[1] 余耀平[1] 

机构地区：[1]湖北职业技术学院,湖北孝感432000

出　　处：《湖北职业技术学院学报》2010年第1期110-112,31,共4页Journal of Hubei Polytechnic Institute

基　　金：湖北职业技术学院科研项目"肠梗阻生长抑素治疗的适应症和时限临床研究"(编号:2008B20)的研究成果

摘　　要：目的:归纳总结一套急性肠梗阻的规范化的治疗方案,减少盲目手术和手术探查阴性率。方法:回顾性分析2005年2月—2008年6月急诊收治的239例肠梗阻患者行有效肠减压的治疗效果。结果:239例患者中,196例患者在有效减压12小时后症状缓解或好转,总的缓解或好转率为82.0%。43例患者在保守治疗无效行急诊手术,总的急诊手术率为18.0%。108例患者完善相关检查,明确诊断后行手术治疗,总的手术率为45.2%。56例粘连性肠梗阻,8例动力性肠梗阻,2例炎性肠病,2例血运性肠梗阻(结合溶栓治疗)和20例不明原因的肠梗阻经保守治疗完全治愈,总的保守治疗有效率为36.8%。结论:有效的减压治疗可作为急性肠梗阻的常规治疗措施,广泛使用于除外绞窄性肠梗阻外的大多数肠梗阻患者,特别是在急诊条件下检查不完善时,诊断困难及原因不明的肠梗阻。Object： To summerize a standardzied treatment of acute intestinal obstruction and to reduce the blind surgery and the rate of negative surgical exploration, Method： A retrospective analysis on the treatmenl effect of 239 emergency intestinal obstruction patients by means of effective intestinal decompression from February 2005 to June 2008. Results： The sympotoms of 196 patients were alleviated after 12 hours by effective decompression, the overall rate of improvement in intigation was 82%. Forty - three patients were operated urgently after the conservative treatment had failed, the overall rate of emergency surgery was 18%. One hundred and eight patients improved relevant examinations and determined to accept surgical treatment after diagnosis, the overall rate of surgery was 45.2%. Forty - six patients of adhensive intestinal obstruction, eight patients of dynamic intestinal obstruction, two patients of inflammatory bowel disease, two patients of mesenteric vascular obstruction （ combined with thrombolytic therapy） and twenty patients of unexplained intestinal obstruction were completely cured by conservative treatment, the overall effective rate of conservative treatment was 36.8%. Conclusion： Effective decompression treatment of acute intestinal obstruction can be used as conventional treatment, except for those with external strangulated intestinal obstruction , and it can be widely applied to most patients ： especially for patients of emergency conditions, inadequate examinations, difficult diagnosis and other unclear reasons.

关 键 词：肠梗阻 急诊 有效肠减压 疗效 

分 类 号：R574.2[医药卫生—消化系统]