目的

分析比较鼻饲泛影葡胺与剖腹手术对术后早期炎性肠梗阻的疗效差异。

方法

回顾性总结43例术后早期炎性肠梗阻患者的治疗方法，泛影葡胺组21例经胃管注入复方泛影葡胺，24 h内腹部X线摄片动态观察造影剂作保守治疗，剖腹手术组22例行黏连松解等术式，比较两组患者的胃管留置时间、恢复排便时间、住院天数、并发症以及再发间期、再发次数。

结果

泛影葡胺组中19例保守治疗成功，平均症状出现缓解时间为16±2.5 h，5～8 d（平均6.8 d）后症状消失；仅2例保守治疗过程中症状体征加重选择手术治疗，中转手术率为9.52%；与剖腹手术组比较，胃管留置时间、恢复排便时间、住院天数均无显著性差异，愈后梗阻再发率（4.76%vs 40.91%，P<0.01）、肺部和切口感染并发症率比较均有统计学意义（P<0.05）。

结论

复方泛影葡胺用于术后早期炎性肠梗阻的保守治疗效果良好，早期鼻饲泛影葡胺能促进炎性肠梗阻的缓解。

Objective

To analyse and evaluate therapeutic value difference between the gastric tube-fed gastrografin and emergency operation for early postoperative inflammatory small bowel obstruction(EPISBO).

Methods

A retrospective study was used for valuing the therapeutic methods of the 43 EPISBO cases.21 cases received the gastric tube-fed compound gastrografin were study group,the position of constrast medium and obstruction were observed with 24 hours abdominal x-ray photographs.22 cases received emergency operations were set control group.The time of gastric tube detain,recovery defecation,stay time and complication,recur interval or times were compared.

Results

In study group,19 cases received expectant treatment were successful.The average symptomatic relief time were 16±2.5 hours,and no symptom after 5～8 (average 6.8)days.Only two cases received operation,the rate of transfer operability were 9.52%.The time of gastric tube detain、recover defecation or be in hospital of the two groups were no difference.But the rates of obstruction recurrence(4.76%vs 40.91%，P<0.01)and complicated infection of bellow or incisional wounds between two groups were different significantly (P<0.05).

Conclusion

The therapeutic efficacy of applying compound gastrografin to expectant treatment of EPISBO is good. Early gastric tube-fed gastrografin will help relieve ileus.