【作者】 任征； 沈朝敏； 费代良； 梁金荣；

【Author】 Ren zheng;Shen chaomin;Fei dailiang;Liang jinrong;Department of General Surgery of Zhoushan;

【机构】 舟山医院普外科；

【摘要】 目的 :探讨肠梗阻导管术中小肠内排列应用于腹部闭合性损伤多发小肠破裂手术,是否有效减轻术后肠粘连,是否有效预防粘连性肠梗阻。方法 :回顾性分析我院2012年1月至2017年1月收治的135例腹部闭合性损伤小肠多发破裂手术患者,按是否术中插入肠梗阻导管分为肠梗阻导管组63例和鼻胃管组72例,统计术后24小时的引流管液体积,48小时腹围变化,白细胞恢复时间,CRP恢复时间,肛门排气时间,随访8月至5年内间断腹胀发生率,粘连性肠梗阻发生率。结果 :肠梗阻导管组24小时胃肠减压量较鼻胃管组明显增多(p<0.05),48小时腹围增幅明显小于鼻胃管组(p<0.05),白细胞恢复时间、CRP恢复时间和肛门排气时间均明显小于鼻胃管组(p<0.05)。术后随访,间断腹胀有3例(4.7%),粘连性肠梗阻2例(3.1%),鼻胃管组间断腹胀15例(20%),粘连性肠梗阻10例(13.8%),两组统计有显著差别(p<0.05)。结论:肠梗阻导管术后小肠内排列可减轻腹部闭合伤多发肠破裂术后肠粘连,预防术后粘连性肠梗阻,且操作简单、安全等优点,可作为具有粘连性肠梗阻高危因素手术的术中选择。更多还原

【Abstract】 Objective To investigate the preventive effect for adhesive intestinal obstruction after multiple intestinal rupture in closed abdominal injury.Methods Retrospective analysis of our hospital in January 2012 to January 2017 treated 135 cases of abdominal closed injury multiple intestinal multiple rupture surgery patients.Divided into intestinal obstruction catheter group 63 cases and nasogastric tube group 72 cases,According to whether to insert a bowel obstruction in operation.To Analysis,statistics 24 hours after the drainage tube fluid volume,48hours abdominal changes,white blood cell recovery time,CRP recovery time and anal exhaust time.To statistics intermittent bloating and adhesive intestinal obstruction during follow-up from 8 months to 5 years.Results The gastrointestinal decompression was significantly higher in the urothelial group than in the nasogastric tube group in 24 hours after operation(p <0.05).The increase of abdominal circumference in 48 hours was significantly lower than that in nasogastric tube group(p <0.05),leukocyte recovery time,CRP recovery time and anal The exhaust time was significantly smaller than that of the nasogastric tube group(p <0.05).There were 3 cases(4.7%) with intermittent bloating,2 cases(3.1%) with adhesive intestinal obstruction,15 cases(20%) with intermittent bloating in the nasogastric tube group,10 cases(13.8%) with adhesive intestinal obstruction,There were significant differences between the two groups(p <0.05).Conclusions Intestinal adhesions can be reduced in multiple intestinal rupture after the abdominal closed injury by inserting intestinal obstruction catheter,And the operation is simple,safe and so on.It Can be used as a intraoperative choice for high risk of adhesive intestinal obstruction surgery.更多还原