羥乙基淀粉在術后早期炎性腸梗阻治療中的作用觀察

洪琛+李于紅+楊鵬+范華平+陳金暉

[摘要] 目的 觀察羥乙基淀粉在術后早期炎性腸梗阻治療中的作用。方法 回顧性分析術后早期炎性腸梗阻患者54例臨床資料。根據不同治療方法分組，對照組給予保守治療，觀察組在此基礎上加用羥乙基淀粉靜滴。觀察兩組患者臨床情況變化。 結果 兩組患者在治療前，一般資料沒有統計學上的差別（P >0.05）。治療結束時，兩組之間治療有效率無統計學意義（P >0.05）。觀察組腹痛腹脹緩解時間、肛門排氣時間、住院天數、胃管拔除時間均低于對照組（P <0.05）。觀察組平均每日胃腸減壓量、電解質紊亂比率明顯優于對照組（P <0.01）。結論 術后早期炎性腸梗阻治療中加用羥乙基淀粉是較佳的選擇。

[關鍵詞] 術后早期炎性腸梗阻；羥乙基淀粉130/0.4氯化鈉注射液；治療

[中圖分類號] R574.2 [文獻標識碼] B [文章編號] 1673-9701（2014）02-0158-03

Effect of hydroxyethyl starch in the treatment to early postoperative inflammatory intestinal obstruction

HONG Chen LI Yuhong YANG Peng FAN Huaping CHEN Jinhui

Department of General Surgery， Luqiao Hospital of Enze Medical Center （Group）of Taizhou in Zhejiang Province， Taizhou 318050， China

[Abstract] Objective To observe the effect of hydroxyethyl starch in the treatment to early postoperative inflammatory intestinal obstruction. Methods A retrospective analysis was given to the treatment to 54 patients with early postoperative inflammatory intestinal obstruction. All patients were randomly divided into two groups. The control group was treated with conservative treatment； the observational group was added with hydroxyethyl starch injection by intravenous drip. Followings were observed clinical changes in the two groups. Results Two groups of patients there were no statistical difference in ordinary circumstances before treatment（P >0.05）. At the end of treatment， no statistical difference was found between the two groups on efficiency （P >0.05）. But， abdominal pain relief time， anal exhaust time， hospital stay and extubation time were shorter in the observational group（P <0.05 ）. Whats more， the average daily volume of gastrointestinal decompression and electrolyte disturbance ratio were significantly better in the observational group than in the control group（P <0.01）. Conclusion Treatment with added hydroxyethyl starch ，Which is a better choice for EPIBO therapy.

[Key words] Early postoperative inflammatory intestinal obstruction； Hydroxyethyl starch 130/0.4 sodium chloride injection； Treatment

術后早期炎性腸梗阻（Early Postoperetive Inflammatory Bowel Obstruction EPIBO）在腹部手術后發生率可達10%，常發生于腹部手術后2周以內，占術后腸梗阻的80%～90%[1]。隨著腹部手術量增多，發病率呈上升趨勢。EPIBO患者如再手術處理不當，易發生腸瘺、廣泛滲血、腹腔內重癥感染、短腸綜合征等嚴重并發癥，且再次術后仍有較高的再梗阻發生機會。因此在治療上往往傾向于非手術治療。我院在該疾病的治療中使用羥乙基淀粉取得較好的療效，現報道如下。

1 資料與方法

1.1一般資料

選取我院普通外科2010年10月～2012年10月收治 的54例術后早期炎性腸梗阻患者，根據治療方法分為觀察組27例和對照組27例。治療組中男15例，女12例；年齡15～68歲，平均年齡40.6歲；術后出現腸梗阻平均時間為7.5 d，其中胃、十二指腸手術6例，小腸手術5例，膽道手術3例，結直腸手術7例，外傷性肝、脾破裂手術2例，闌尾切除術4例。對照組中……