行肠梗阻导管肠腔内排列治疗对腹茧症的效果比较  

Novel Therapy for Abdominal Cocoon:arranging nasointestinal obstruction tube during surgery

作　　者：宁势力[1] 郭进[1] 罗福文[1] 

机构地区：[1]大连医科大学附属第二医院急腹症外科,辽宁大连116023

出　　处：《医学与哲学（B）》2015年第10期32-33,96,共3页Medicine & Philosophy(B)

摘　　要：探讨手术中行肠梗阻导管肠腔内排列治疗腹茧症的方法和疗效。纳入2009年5月～2014年5月手术中行肠梗阻导管肠腔内排列治疗腹茧症患者9例，纳入同时期手术中未行肠排列（胃管减压）治疗腹茧症患者12例。结果与胃管减压组相比，行肠排列组每日负压引流量明显升高（P〈0．001）。在6个月的随访中，与胃管减压组相比，行肠排列组显著降低术后粘连性肠梗阻再发（P=0．0349）。手术中行肠梗阻导管肠腔内排列可显著降低腹茧症患者术后粘连性肠梗阻，具有巨大的临床推广价值。Abdominal cocoon （AC） is a rare disease with a poorly elucidated pathophysiology, characterized by the constitution of a thick fibrosis membrane that wraps the total or partial bowel in a cocoon like fashion. Our purpose was to investigate an advanced therapy for AC. The clinical manifestations, surgical intervention, and follow-up results of 21 patients who were diagnosed as AC from May 2009 to May 2014 were retrospectively reviewed. 21 cases were divided into two groups： the group arranging nasointestinal obstruction tube during operation （NIT, 9 cases） and the group only using nasogastric tube （NGT, 12 cases）. The 21 patients （17 male, 4 female） had a median age of 51 years （range 21 years-72 years）. Compared with NGT group, NIT group had significantly more draining juice （P〈0. 001）. Most important, NIT group bad a lower incidence of postoperative adhesive obstruction than NGT group during 6 months of follow-up （P = 0. 034 9）. Arranging nasointestinal obstruction tube during operation for abdominal cocoon to prevent recurrent small bowel obstruction is safe and effective, when used on appropriately selected patients. Its effectiveness should be more widely recognized.

关 键 词：腹茧症 肠梗阻导管 小肠排列术 

分 类 号：R656[医药卫生—外科学]