术后肠梗阻的治疗进展  

Progress in the treatment of postoperative ileus

作　　者：戴凌[1] 蒋志庆[1] DAI Ling;JIANG Zhiqing(Dept,of Gastrointestinal Surgery,the Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院胃肠外科,广西桂林541001

出　　处：《华夏医学》2019年第4期173-176,共4页Acta Medicinae Sinica

基　　金：广西卫计委科研课题资助项目(Z20170858)。

摘　　要：术后肠梗阻(postoperative ileus,POI)是指术后肠道动力障碍导致肠内气体传输变缓和术后排便延迟,常常持续4〜5d。术后肠梗阻的发生机制包括神经系统因素、炎症反应、激素改变以及麻醉镇痛剂的影响。目前用于治疗术后肠梗阻的主要措施包括非药物治疗措施和药物治疗。非药物治疗措施包括咀嚼口香糖、电针治疗、按摩腹部、早期进食、纠正电解质紊乱和术后早期喝咖啡等,已进入临床使用或正在研究中的药物则有从μ-阿片受体拮抗剂、胆碱酯酶抑制剂,5-HT4受体激动剂、脑肠肽受体激动剂、红霉素、缓泻剂和中草药类药物等。Postoperative Ileus(PO1)refers to a delay in defecation,usually lasting for 4 to 5 days,caused by postoperative intestinal dystrophy that leads to the relaxation of intestinal gas transmission.The mechanisms of postoperative ileus include neurological factors,inflammatory responses,hormonal changes,and the effects of analgesics.At present,the main measures used to treat postoperative ileus include non-drug therapy and drug therapy.Non-drug treatment measures include chewing gum,cupping therapy,abdomen massage,early feeding,the correction of electrolyte disorder and early postoperative coffee drinking,etc..Drug therapy includes the clinical use or under study of drugs,which areμ-opioid receptor antagonist,cholinesterase inhibitors,5-HT4 agonists,ghrelin agonists,erythromycin,sugarrefining and herbal drugs,etc.

关 键 词：术后肠梗阻 非药物治疗 药物治疗 胃肠道动力 

分 类 号：R574.2[医药卫生—消化系统] R656.1[医药卫生—内科学]