• 廣東省深圳市寶安區(qū)人民醫(yī)院普外科(廣東深圳 518101);

目的探討由石蠟油、二甲硅油及番瀉葉制劑組成的混合性制劑在術(shù)后粘連性不全性腸梗阻非手術(shù)治療中的價(jià)值。方法將我院2005年3月至2008年5月期間收治的128例術(shù)后粘連性不全性腸梗阻成人患者隨機(jī)分為對(duì)照組和治療組2組。對(duì)照組(n=52)行常規(guī)的禁食，胃腸減壓，補(bǔ)液治療，肥皂水保留灌腸； 治療組(n=76)在對(duì)照組治療的基礎(chǔ)上，胃管內(nèi)注入由石蠟油、二甲硅油及番瀉葉制劑組成的混合性制劑。分析比較2組之間結(jié)果的差異，包括: 非手術(shù)治療成功率，梗阻癥狀完全緩解后恢復(fù)正常排氣、排便的時(shí)間，恢復(fù)正常飲食的時(shí)間，以及復(fù)發(fā)率。結(jié)果非手術(shù)治療成功率對(duì)照組為69.2%(36/52),治療組為92.1%(70/76)，治療組明顯高于對(duì)照組(P lt;0.01)?；謴?fù)正常排氣、排便平均時(shí)間對(duì)照組為47.8 d，治療組為32.5 d； 恢復(fù)正常飲食平均時(shí)間對(duì)照組為5.3 d，治療組為3.2 d。治療組恢復(fù)正常排氣、排便及恢復(fù)正常飲食的平均時(shí)間均明顯短于治療組(P lt;0.01)。2組復(fù)發(fā)率差異無統(tǒng)計(jì)學(xué)意義(P gt;0.05)。結(jié)論應(yīng)用由石蠟油、二甲硅油及番瀉葉制劑組成的混合性制劑可促進(jìn)腸功能恢復(fù)，降低其外科手術(shù)的干預(yù)率。

引用本文： 王甘露,侍立志,賀德,黎惠娟,劉美群,陳暉,黃波. 術(shù)后粘連性不全性腸梗阻的非手術(shù)治療. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(3): 286-289. doi: 復(fù)制

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2. Menzies D, Parker M, Hoare R, et al. Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions [J]. Ann R Coll Surg Engl, 2001, 83(1): 4046.
3. Miller G, Boman J, Shrier I, et al. Natural history of patients with adhesive small bowel obstruction [J]. Br J Surg, 2000, 87(9): 12401247.
4. 胡孔旺, 朱化剛, 耿小平, 等. 粘連性腸梗阻手術(shù)指征多因素分析 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(9): 939943.
5. Ray NF, Larsen JW Jr, Stillman RJ, et al. Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988 [J]. Surg Gynecol Obstet, 1993, 176(3): 271276.
6. Seror D, Feigin E, Szold A, et al. How conservatively can postoperative small bowel obstruction be treated? [J]. Am J Surg, 1993, 165(1): 121125.
7. Assalia A, Schein M, Kopelman D, et al. Therapeutic effect of oral gastrografin in adhesive, partial smallbowel obstruction: a prospective randomized trial [J]. Surgery, 1994, 115(4): 433437.
8. Jeekel H. Cost implications of adhesions as highlighted in a European study [J]. Eur J Surg, 1997, 579(Suppl): 4345.
9. 張延齡. 腹膜粘連的形成及防治 [J]. 國外醫(yī)學(xué)外科學(xué)分冊(cè), 1981, 1: 17.
10. Cheynel N, Cortet M, Lepage C, et al. Trends in frequency and management of obstructing colorectal cancers in a welldefined population [J]. Dis Colon Rectum, 2007, 50(10): 15681575.
11. 章曉璟, 俞建平. 口服泛影葡胺聯(lián)合中藥治療粘連性腸梗阻 [J]. 浙江臨床醫(yī)學(xué), 2006, 8(7): 700.
12. Chen SC, Lin FY, Lee PH, et al. Watersoluble contrast study predicts the need for early surgery in adhesive small bowel obstruction [J]. Br J Surg, 1998, 85(12): 16921694.
13. Chen SC, Chang KJ, Lee PH, et al. Oral urografin in postoperative small bowel obstruction [J]. World J Surg, 1999, 23(10): 10511054.
14. 隋國德, 胡三元, 牛兆健, 等. 中西醫(yī)結(jié)合治療急性粘連性腸梗阻216例 [J]. 浙江中西醫(yī)結(jié)合雜志, 2006, 16(5): 303304.
15. 黃宏漢, 孫淑明, 江樹嵩. 腸粘連通暢湯臨床應(yīng)用研究 [J]. 醫(yī)學(xué)通報(bào), 2006, 5(2): 4244.
16. 史玉紅. 粘連性不全性腸梗阻的綜合治療 [J]. 西部醫(yī)學(xué), 2006, 18(5): 626.
17. 鐘德源, 歐志平, 管奇峰. 奧曲肽治療粘連性腸梗阻療效觀察 [J]. 中華現(xiàn)代外科雜志, 2005, 2(10): 928929.
18. 姚宏偉, 傅衛(wèi), 袁炯, 等. 經(jīng)鼻腸減壓管在治療急性粘連性小腸梗阻中的作用研究 [J]. 中華普通外科雜志, 2006, 21(10): 754755.
19. 潘雷. 149例粘連性腸梗阻診治體會(huì) [J]. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(6): 434435.
20. 張毅, 侯勇, 侯昌映, 等. 泛影葡胺胃腸道造影在粘連性腸梗阻中的臨床應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志， 2006, 13(5): 595596.
21. Tabibian JH. Management of highgrade smallbowel obstruction [J]. Arch Surg, 2010, 145(4): 404405.
22. Chen SC, Lee CC, Yen ZS, et al. Specific oral medications decrease the need for surgery in adhesive partial smallbowel obstruction [J]. Surgery, 2006, 139(3): 312316.
23. LengPeschlow E. Acceleration of large intestine transit time in rats by sennosides and related compounds [J]. J Pharm Pharmacol, 1986, 38(5): 369373.
24. 于世英, 王杰軍, 王金萬, 等. 晚期癌癥患者合并腸梗阻治療的專家共識(shí) [J]. 中華腫瘤雜志, 2007, 29(8): 637640.
  1. 1. Wilson MS, Hawkswell J, McCloy RF. Natural history of adhesional small bowel obstruction: counting the cost [J]. Br J Surg, 1998, 85(9): 12941298.
  2. 2. Menzies D, Parker M, Hoare R, et al. Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions [J]. Ann R Coll Surg Engl, 2001, 83(1): 4046.
  3. 3. Miller G, Boman J, Shrier I, et al. Natural history of patients with adhesive small bowel obstruction [J]. Br J Surg, 2000, 87(9): 12401247.
  4. 4. 胡孔旺, 朱化剛, 耿小平, 等. 粘連性腸梗阻手術(shù)指征多因素分析 [J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(9): 939943.
  5. 5. Ray NF, Larsen JW Jr, Stillman RJ, et al. Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988 [J]. Surg Gynecol Obstet, 1993, 176(3): 271276.
  6. 6. Seror D, Feigin E, Szold A, et al. How conservatively can postoperative small bowel obstruction be treated? [J]. Am J Surg, 1993, 165(1): 121125.
  7. 7. Assalia A, Schein M, Kopelman D, et al. Therapeutic effect of oral gastrografin in adhesive, partial smallbowel obstruction: a prospective randomized trial [J]. Surgery, 1994, 115(4): 433437.
  8. 8. Jeekel H. Cost implications of adhesions as highlighted in a European study [J]. Eur J Surg, 1997, 579(Suppl): 4345.
  9. 9. 張延齡. 腹膜粘連的形成及防治 [J]. 國外醫(yī)學(xué)外科學(xué)分冊(cè), 1981, 1: 17.
  10. 10. Cheynel N, Cortet M, Lepage C, et al. Trends in frequency and management of obstructing colorectal cancers in a welldefined population [J]. Dis Colon Rectum, 2007, 50(10): 15681575.
  11. 11. 章曉璟, 俞建平. 口服泛影葡胺聯(lián)合中藥治療粘連性腸梗阻 [J]. 浙江臨床醫(yī)學(xué), 2006, 8(7): 700.
  12. 12. Chen SC, Lin FY, Lee PH, et al. Watersoluble contrast study predicts the need for early surgery in adhesive small bowel obstruction [J]. Br J Surg, 1998, 85(12): 16921694.
  13. 13. Chen SC, Chang KJ, Lee PH, et al. Oral urografin in postoperative small bowel obstruction [J]. World J Surg, 1999, 23(10): 10511054.
  14. 14. 隋國德, 胡三元, 牛兆健, 等. 中西醫(yī)結(jié)合治療急性粘連性腸梗阻216例 [J]. 浙江中西醫(yī)結(jié)合雜志, 2006, 16(5): 303304.
  15. 15. 黃宏漢, 孫淑明, 江樹嵩. 腸粘連通暢湯臨床應(yīng)用研究 [J]. 醫(yī)學(xué)通報(bào), 2006, 5(2): 4244.
  16. 16. 史玉紅. 粘連性不全性腸梗阻的綜合治療 [J]. 西部醫(yī)學(xué), 2006, 18(5): 626.
  17. 17. 鐘德源, 歐志平, 管奇峰. 奧曲肽治療粘連性腸梗阻療效觀察 [J]. 中華現(xiàn)代外科雜志, 2005, 2(10): 928929.
  18. 18. 姚宏偉, 傅衛(wèi), 袁炯, 等. 經(jīng)鼻腸減壓管在治療急性粘連性小腸梗阻中的作用研究 [J]. 中華普通外科雜志, 2006, 21(10): 754755.
  19. 19. 潘雷. 149例粘連性腸梗阻診治體會(huì) [J]. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(6): 434435.
  20. 20. 張毅, 侯勇, 侯昌映, 等. 泛影葡胺胃腸道造影在粘連性腸梗阻中的臨床應(yīng)用 [J]. 中國普外基礎(chǔ)與臨床雜志， 2006, 13(5): 595596.
  21. 21. Tabibian JH. Management of highgrade smallbowel obstruction [J]. Arch Surg, 2010, 145(4): 404405.
  22. 22. Chen SC, Lee CC, Yen ZS, et al. Specific oral medications decrease the need for surgery in adhesive partial smallbowel obstruction [J]. Surgery, 2006, 139(3): 312316.
  23. 23. LengPeschlow E. Acceleration of large intestine transit time in rats by sennosides and related compounds [J]. J Pharm Pharmacol, 1986, 38(5): 369373.
  24. 24. 于世英, 王杰軍, 王金萬, 等. 晚期癌癥患者合并腸梗阻治療的專家共識(shí) [J]. 中華腫瘤雜志, 2007, 29(8): 637640.