慢性假性肠梗阻患者43例临床特征分析  

Clinical characteristics of chronic intestinal pseudo-obstruction ： an analysis of 43 cases

作　　者：李晓青[1] 舒慧君[1] 费贵军[1] 方秀才[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化内科,北京100730

出　　处：《中华全科医师杂志》2017年第9期672-675,共4页Chinese Journal of General Practitioners

摘　　要：目的总结分析慢性假性肠梗阻（chronicintestinalpseudo．obstruction，CIPO）患者的临床特征。方法回顾性分析2012年1月至2016年12月北京协和医院诊断为CIPO的43例住院患者的临床资料，对患者的临床表现、实验室检查、影像学表现、治疗及预后等进行总结。结果43例患者中男性14例，女性29例，平均年龄（41．9±16．1）岁。就诊于消化内科32例，普通内科6例，免疫内科5例。原发性CIPO22例，继发性CIPO21例。主要临床表现为腹胀40例（93．0％）、腹痛29例（67．4％）、呕吐29例（67．4％）、腹泻20例（46．5％）、便秘18例（41．9％），43例患者均有体质量和BMI下降。23．3％（10／43）患者合并焦虑抑郁情绪；53．5％（23／43）患者合并不同程度的贫血，55．8％（24／43）患者合并低白蛋白血症。所有患者肠梗阻发作时行立位腹平片均提示存在肠梗阻，但CT和消化道造影均未提示机械性梗阻。CIPO患者平均住院时间（28．4±13．9）d，23例患者行胃管减压，肠外营养28例（65．1％），肠内营养支持21例（48．8％），8例患者共经历过9次腹部手术。结论CIPO临床少见，出现肠梗阻表现但无机械性证据时需警惕CIPO，并筛查继发因素，处理上避免不必要的外科手术。Objective To analyze the clinical characteristics of chronic intestinal pseudoobstruction （CIPO）.Methods Clinical data of 43 patients with CIPO admitted in Peking Union Medical College Hospital from January 2012 to December 2016 were retrospectively reviewed.The clinical manifestations,laboratory examinations,images,treatment and prognosis of CIPO patients were analyzed.Results There were 14 males and 29 females with an mean age of （41.9±16.1） years.Among 43 patients,32 were admitted in Gastroenterology Department,6 in General Medicine Department and 5 in Rheumatology Department.Twenty two cases were primary CIPO and 21 cases were secondary.The main clinical manifestations were abdominal distension （93.0%）,abdominal pain （67.4%）,vomiting （67.4%）,diarrhea （46.5%） and constipation （41.9%）.All 43 patients had decreased body weight and body mass index （BMI）;23.3% （10/43） patients were complicated with anxiety and depression.53.5% （23/43） patients presented anemia and 55.8% （24/43） patients presented hypoalbuminemia.All patients with CIPO underwent abdominal X-ray,which showed intestinal obstruction;but there was no evidence of mechanical obstruction.The average length of hospital stay was （28.4 ± 13.9） d.Twenty three cases underwent gastric decompression;28 cases （65.1%） received parenteral nutrition,and 21 cases （48.8%） received enteral nutrition;and 9 abdominal operations were performed in 8 patients.Conclusion When clinical symptoms of intestinal obstruction appear without mechanical cause,CIPO should be considered and secondary factors should be screened.Unnecessary surgery should be avoided in CIPO patients.

关 键 词：肠假性梗阻 疾病特征 慢性 

分 类 号：R574.2[医药卫生—消化系统]