RESUMO
Postoperative intestinal obstruction,also known as postoperative small bowel obstruction(PSBO),is the most common acute abdomen after abdominal operations. The key to the treatment is accurate determination of therapeutic strategy.While avoiding unnecessary operation,delayed operation will cause intestinal obstruction and endanger the patients. PSBO diagnosis was improved owing to the progress of imaging techniques. Contrast enhanced CT can reach 90% in the diagnostic accuracy of intestinal strangulation,necessity of emergency operation and elucidation of etiology. Intestinal decompression via small intestinal decompression tube and subsequent gastrografin challenge can promote resolution of PSBO,increase the success rate of nonoperative management,avoid operation delay,and shorten the length of hospital stay.Operation is indicated for repeated episode of PSBO to eliminating the cause and avoiding recurrence. Elective operation is preferred over emergency. Laparoscopic operation is indicated for simple adhesions,but laparotomy is indicated for complex one. Meticulous operation,either laparoscopic or laparotomic,intestinal protection and eliminating foreign material and tissue debris are the keys to the prophylaxis of PSBO.
RESUMO
Objective: To investigate the effect of the smal l intestinal decompression on intra-abdominal hypertension(IAH) in critically ill patients. Methods:Fourteen IAH patients received small intestinal decompression under the X ray in Navy General Hospital of PLA from August 2013 to August 2015, and the heart rate, mean arterial pressure, breathing rate, abdominal perimeter, urea nitrogen, creatinine, urine output per hour, 24-h intra-abdominal pressure after decompression, and lactic acid before and after the decompression were examined and recorded. Results After decompression all the patients' heart rate, breathing rate, abdominal perimeter, intra-abdominal pressure significantly decreased (P0.05). Conclusion Transnasal small intestinal decompression is safe and effective for the critically ill patients with intra-abdominal hypertension.
RESUMO
Objective To compare the success rate, operation time, complication rate and the degree of tolerance of two kinds of endoscopic placement of small intestine decompression tube. Method 68 intestinal obstruction patients treated with transnasal ileus tube were randomly divided into 2 groups, group A and group B, 34 cases in each. Patients in group A were treated by endoscopic placement, while in group B placement was guided by nasal endoscope. Results The catheterization success rate and complications between the two groups have no statistical significance (P > 0.05) while the differences of catheter operation time (P < 0.05) and placement tolerance (P < 0.01) have statistical significance. Conclusion Endoscopic placement of small intestinal decompression tube has clinical application value while placement guided by nasal endoscope has certain advantages.