术后粘连性不全性肠梗阻的非手术治疗  

Clinical Research on Nonoperative Treatment for Incomplete Adhesive Small Bowel Obstruction after Laparotomy

作　　者：王甘露[1] 侍立志[1] 贺德[1] 黎惠娟[1] 刘美群[1] 陈晖[1] 黄波[1] 

机构地区：[1]广东省深圳市宝安区人民医院普外科,广东深圳518101

出　　处：《中国普外基础与临床杂志》2011年第3期286-289,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：深圳市宝安区科技计划项目(项目编号:2007026)~~

摘　　要：目的探讨由石蜡油、二甲硅油及番泻叶制剂组成的混合性制剂在术后粘连性不全性肠梗阻非手术治疗中的价值。方法将我院2005年3月至2008年5月期间收治的128例术后粘连性不全性肠梗阻成人患者随机分为对照组和治疗组2组。对照组(n=52)行常规的禁食,胃肠减压,补液治疗,肥皂水保留灌肠;治疗组(n=76)在对照组治疗的基础上,胃管内注入由石蜡油、二甲硅油及番泻叶制剂组成的混合性制剂。分析比较2组之间结果的差异,包括:非手术治疗成功率,梗阻症状完全缓解后恢复正常排气、排便的时间,恢复正常饮食的时间,以及复发率。结果非手术治疗成功率对照组为69.2%(36/52),治疗组为92.1%(70/76),治疗组明显高于对照组(P<0.01)。恢复正常排气、排便平均时间对照组为47.8 d,治疗组为32.5 d;恢复正常饮食平均时间对照组为5.3 d,治疗组为3.2 d。治疗组恢复正常排气、排便及恢复正常饮食的平均时间均明显短于治疗组(P<0.01)。2组复发率差异无统计学意义(P>0.05)。结论应用由石蜡油、二甲硅油及番泻叶制剂组成的混合性制剂可促进肠功能恢复,降低其外科手术的干预率。Objective To study the application value of mixed formulations consisting of paraffin oil,dimethyl silicone oil,and senna preparations in treatment for incomplete adhesive intestinal obstruction after laparotomy.Methods One hundred and twenty-eight patients diagnosed incomplete adhesive intestinal obstruction admitted to this hospital from March 2005 to May 2008 were randomly divided into trial group and control group.For the control group,the tradition therapy including fasting,gastrointestinal decompression,fluid replacement therapy,and enema with soap and water were used for treatment.For the trial group,the mixed formulations consisting of paraffin oil,dimethyl silicone oil,and senna preparations were injected into stomach by the nasogastric tube on the basis of traditional treatment used for the control group.Some indicators including the successful rate of nonoperative treatment,the time that obstructive symptoms resolved and returned to normal exhaust and defecation and normal diet,and recurrence rate were compared between two groups.Results The successful rate of nonoperative treatmentin in the trial group were significantly higher than that in the control group（92.1%（70/76） versus 69.2%（36/52）,P0.01）.The average time that recovered to normal exhaust and defecation in the trial group and the control group was 32.5 d and 47.8 d,respectively.The average time that recovered to normal diet in the trial group and the control group was 3.2 d and 5.3 d,respectively.The time that recovered to normal exhaust and defecation,and diet in the trial group were significantly shorter than those in the control group（P0.01）.The recurrence rate had no significant difference between two groups（P0.05）.Conclusion The mixed formulations consisting of paraffin oil,dimethyl silicone oil,and senna preparations improve recovery of intestinal function and reduce surgical intervention rate.

关 键 词：小肠梗阻 粘连 二甲硅油 非手术治疗 腹部手术 

分 类 号：R656.7[医药卫生—外科学]