Clinical characteristics and treatment strategies of patients with early inflammatory ileus after gynecological surgery
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摘要:目的 探讨妇科手术后早期炎性肠梗阻的临床特点及治疗原则。方法 回顾性分析15例妇科手术后早期炎性肠梗阻患者的临床资料。结果 15例患者中, 7例在妇科手术后2~4 d出现肠梗阻症状, 4例在术后5~6 d出现, 4例在术后8~12 d出现症状，表现为腹痛、腹胀及肛门停止排便、排气。腹部平片提示立位明显液平，卧位明显肠胀气。15例患者根据症状、体征、辅助检查在妇科手术后确诊，经禁食、胃肠减压、营养支持、应用生长抑素等保守治疗后均治愈，随访1个月至半年未见肠梗阻复发。结论 术后早期炎性肠梗阻多发生于术后2周内，宜采用保守治疗方式，患者预后良好。Abstract:Objective To investigate the clinical characteristics and treatment strategies of early inflammatory ileus after gynecological surgery.Methods The clinical data of 15 cases with early inflammatory ileus after gynecological surgery in our hospital were retrospectively analyzed.Results Out of the 15 patients, intestinal obstruction symptoms occurred in 7 cases at 2 to 4 days after gynecological operation, 4 cases at 5 to 6 days after operation, and 4 cases at 8 to 12 days after operation. The symptoms manifested as abdominal pain and distension as well as anal dysfunction in defecation and exhaust. The plain abdominal film showed that the intestinal liquid was flat in standing position, and intestinal flatulence in lying position. Fifteen patients were confirmed as intestinal obstruction according to symptoms, signs and auxiliary examinations. All patients were cured after conservative treatment including fasting, gastrointestinal decompression, nutritional support and somatostatin. There was no recurrence of intestinal obstruction during 1 to 6 months follow-up.Conclusion Early postoperative inflammatory intestinal obstruction usually occurs within 2 weeks after operation. Conservative treatment is appropriate for better prognosis.
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