lin91957
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 Posted: Wed 19:02, 23 Mar 2011 Post subject: mbt chaussures paris 48 cases of early postoperati |
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48 cases of early postoperative diagnosis and treatment of inflammatory intestinal obstruction
O1 clinical manifestations of early postoperative inflammatory ileus and treatment has its particularity, if not handled properly can cause intestinal fistula, severe infections and other serious complications. Our hospital in January 1996 ~ January 2005 early postoperative inflammatory ileus were treated 48 patients, reported as follows. 1 1.1 General Information The clinical data of 48 patients 33 cases of male and female l5 cases. Age of l4 ~ 65 years, mean 49 years old. Perforation of acute appendicitis after appendectomy in 22 cases, most of gastroduodenal perforation of gastric resection in 8 cases,[link widoczny dla zalogowanych], 9 cases of small bowel surgery, colon surgery, 5 cases of traumatic rupture of 4 patients after splenectomy . Symptoms occurred after 4 ~ l8-day, 7 days l8 cases, 8 to 14 days 2l cases, l5 an l8-day in 9 cases. All groups had abdominal distension, abdominal pain 45 cases,[link widoczny dla zalogowanych], nausea, vomiting 42 cases, 47 cases to stop the exhaust defecation. Abdominal tenderness in 44 cases with a fixed, 6 cases of palpable tenderness of the mass. Abdominal plain film X ray taken: All the patients were seen more fluid level. Abdominal CT examination in 26 cases, all showed bowel wall edema, thickening,[link widoczny dla zalogowanych], ill-defined and intestinal fluid product gas, a high degree of expansion of the intestine no. 1.2 Treatment and outcome of the patients were treated conservatively: (1) fasting, continuous gastrointestinal decompression to ileus symptoms disappeared; (2) maintain water and electrolyte and acid-base balance, and intravenous nutritional support; ( 3) combined antibiotics; (4) application of adrenocorticotropic hormone and somatostatin; (5), abdominal distension and to reduce the gastric tube after injection of traditional Chinese medicine compound Dachengqi soup 150 ~ 20Oral, pinch 20 ~ 30min, each Et2 times. Results: 48 cases 1 case of non-strangulated intestinal obstruction, all cured. Symptoms of intestinal obstruction in 6 days after treatment began to ease 3 II, 6 to 20 days after treatment, the symptoms subsided, the average l4 days the symptoms completely subsided. 2.1 Diagnosis 2 discussions is due early postoperative inflammatory ileus or abdominal surgery, abdominal trauma and other causes intestinal inflammation, edema and exudates, forming a mechanical and dynamic obstruction coexist. Inflammation leads to reduced peristalsis is caused by obstruction of the main reasons, followed by intestinal obstruction caused by bowel wall edema]. The disease has the following main clinical features: (1) of the disease more common in a wide range of surgical procedures, trauma weight, operation time, and serious cases of peritoneal inflammation; (2) the vast majority of cases in the unit: 541,100 Guangxi Lingui, temporary County,[link widoczny dla zalogowanych], Guangxi People's Hospital, 5 days after surgery 2 weeks onset, often have exhaust defecation, after eating obstruction, and symptoms gradually worsened; (3) the main symptoms of abdominal distention, abdominal pain and relatively light; (4) intestinal obstructive symptoms and signs are typical, but less likely to strangulation; (5) Notwithstanding the mechanical factors, but most are caused by extensive intra-abdominal adhesions due to inflammation; (6) The most effective conservative treatment. According to the clinical symptoms and signs, combined with abdominal x-ray, radiography revealed multiple fluid levels, and signs of fluid within the intestine; abdominal CT scan shows bowel wall thickening, intestinal loops into the group, the intestine is no contrast, etc. J, and more can be diagnosed. 2.2 Treatment of conservative treatment is the treatment of early postoperative inflammatory ileus only way 3. Early postoperative inflammatory intestinal obstruction due to adhesions caused by a high degree of edema and dense, rather than a place of mechanical bowel obstruction, can not be discharged through the surgery, if the forced separation of the small intestine caused by multiple rupture easily, leading to intestinal fistula and severe infection and other serious complications. All patients in this group with conservative treatment, 1 case of non-strangulated intestinal obstruction, were cured. That early postoperative inflammatory ileus conservative treatment is safe and effective. We believe that standardized treatment is to ensure that the key to successful treatment. Fasting, gastrointestinal decompression is to ensure sustained and effective treatment of the foundation, to reduce bloating stomach tube after the injection of traditional Chinese medicine regularly to re-Dachengqi soup can promote bowel movements will help shorten the course. Obstruction caused by intra-abdominal inflammation is the main reason for antibiotic treatment should be strengthened. Adrenal cortex hormones help reduce the intestinal wall edema, and promote inflammation subsided and adhesiolysis. Reduce the use of somatostatin secretion of digestive juice is conducive to stable internal environment. Timely, reasonable,[link widoczny dla zalogowanych], and adequate nutrition support is the main part of treatment for patients, 3L bag can keep the patient application of physical strength, reduce gastrointestinal secretion, inflammation of the gastrointestinal tract to promote an early recovery. 【
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