剖宫产手术后急性结肠假性梗阻15例临床分析  

Clinical Analysis on 15 Cases of Acute Colon Pseudo-obstruction Following Cesarean Section

作　　者：陈根秀 

机构地区：[1]浙江省丽水市缙云县第二人民医院,浙江丽水321404

出　　处：《中国肛肠病杂志》2013年第4期59-60,共2页Chinese Journal of Coloproctology

摘　　要：为探讨剖官产手术后急性结肠假性梗阻的临床特点及防治方法，回顾分析15例剖宫产手术后急性结肠假性梗阻患者的临床资料。结果显示，剖宫产原因为活跃期延长6例，第二产程延长4例，重度妊高症2例，社会因素3例；肠梗阻发生于术后（3．12±1．01）d；均有中重度腹胀，肛门停止排气排便10例，腹泻5例；肠鸣音减弱13例，肠鸣音消失1例，肠鸣音正常1例；轻度低钾、低钠血症2例；X线腹部平片均可见盲肠、升结肠和横结肠扩张，直径（8．12±0．39）cm，无明显液气平面；12例经保守治疗治愈，3例肠管进行电子结肠镜减压后症状缓解。结果表明，剖宫产术后急性结肠假性梗阻患者具有自身临床特点，及时诊断治疗患者预后较好，避免产程延长、手术操作轻柔、术后适当早活动可减少其发生。In order to explore the clinical features and prevention ＆ treatment of acute colon pseudo-ob- struction after cesarean section,author retrospectively analyzed the clinical data of 15 cases with above dis- ease. As results, 1）the causes of cesarean section： 6 cases were due to prolonged activity phase,4 due to the second labor extended,2 were of severe pregnancy hypertension, 3 induced by social factors. 2）manifesta- tion and management：obstruction occured at （3.12± 1.01）days after section, all of 15 cases had mid-and severe burbulence,among them 10 cases had stopped defecation and flatus,5 were of diarrhea; 13 were of rugitus sound weakened,one case was of rugitus sound disappeared,one was normal;2 of 15 cases suffered from hypokalemia and hyponatremia; abdomen X-ray plainfilm showed enlarged blindgut, ascending colon and transverse colon, with diameter of （8.12±0.39）em, but no significant fluid and gas level; 12 of 15 cases were cured with conservation therapy, rest 3 cases received electro-colonoscopy and depression then their symptoms relieved. Results show that acute colon pseudo-obstruction has it self clinical features, if timely diagnosing ＆ treating it can make prognosis of patients better; besides,preventing from labor prolonged, performing operation gently, as early as doing appropriate activity can reduce incidence of it.

关 键 词：急性结肠假性梗阻 剖宫产 治疗 预防 

分 类 号：R574.62[医药卫生—消化系统]