直肠癌术后早期肠梗阻57例临床诊治探讨  

Early diagnosis and treatment of 57 cases with colorectal cancer postoperative ileus

作　　者：俞宏斌[1] 沈福兴 朱炜[1] 戴闯[1] 

机构地区：[1]湖州市第一人民医院分子外科研究所湖州师范学院附属第一医院普外科,浙江省湖州313000 [2]湖州市吴兴区人民医院外科,浙江省湖州313000

出　　处：《中国基层医药》2017年第3期382-386,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：分析直肠癌术后早期肠梗阻的有效预防和处理的方法。方法回顾性分析57例直肠癌术后早期肠梗阻患者的临床资料，包括禁食、胃肠减压、补液抗炎、液状石蜡、泛影葡胺口服造影及手术治疗等。结果57例患者中，麻痹性肠梗阻7例，保守治疗后均缓解，成功率100．0％；早期炎性肠梗阻37例经保守治疗36例缓解，成功率97．3％；机械性肠梗阻13例经保守治疗无法缓解，保守成功率0．0％，再次手术治愈。前两组患者与机械性肠梗阻患者比较，保守成功率差异均有统计学意义（χ2＝40．08、11．08，均 P＜0.01）。结论直肠癌术后早期肠梗阻处理关键在于有效预防、早期发现、严密观察和及时有效处理，把握好手术时机和手术适应证。Objective To explore how to effectively prevent and detect cancer early postoperative intestinal obstruction and treatment methods and means.Methods This retrospective analysis of 13 years occurred in 57 patients with rectal cancer diagnosis and treatment of cases of early postoperative intestinal obstruction process, including fasting,gastrointestinal decompression,fluid therapy,liquid paraffin,diatrizoate and surgical treatment of oral contrast.Results In 57 cases,paralytic intestinal obstruction in 7 cases,conservative treatment was relieved,the success rate was 100.0%;early inflammatory intestinal obstruction in 37 cases after conservative treatment of 36 cases of remission,the success rate was 97.3%;mechanical intestinal obstruction in 13 cases after conservative treatment could not be alleviated,conservative success rate was 0.0% and was cured by reoperation.The first two groups of patients compared with mechanical intestinal obstruction patients,conservative success rate had statistical differences （χ2 =40.08,11.08,all P〈0.01）.Conclusion Cancer treatment lies in early postoperative intestinal obstruction effective prevention,early detection,close observation and timely and effective treatment,a good grasp of timing of surgery and surgical indications.

关 键 词：直肠肿瘤 肠梗阻 治疗 

分 类 号：R735.37[医药卫生—肿瘤]