摘要目的 评价、比较鼻肠减压导管以及奥曲肽,在腹部手术后早期炎症性肠梗阻保守治疗中的作用.方法 2005年3月至2009年1月期间45例腹部手术后早期炎症性肠梗阻的患者,使用鼻胃管减压等常规保守治疗无效后,非随机分为肠减压导管治疗组(23例)以及奥曲肽治疗组(22例),比较两种治疗方法与常规保守治疗方法以及两种治疗方法之间的疗效差别.结果 经鼻胃管减压的常规保守治疗无效的45例患者,经过上述两种治疗方法的保守治疗,3-12 d所有患者的肠梗阻均得以缓解;与奥曲肽治疗组相比,肠减压导管治疗组的自主排气时间更短[(4.7±1.9)d比(6.7 ±1.6)d]、腹围恢复得更快[(90.4±2.0)%比(95.1±1.3)%],但累计胃肠减压量[(4037±1155)ml比(3316±1038)m1]及日均胃肠减压量[(890±181)ml比(492±83)ml均更多,两组差异均有统计学意义(P均＜0.05).结论 肠减压导管以及奥曲肽治疗术后早期炎症性肠梗阻安全有效,肠减压导管的治疗时间更短,奥曲肽能够降低胃肠减压量.

abstractsObjective To evaluate and compare the effect of nasointestinal tube decompression and octreotide in conservative management of early post-operative inflammatory ileus(EPII).Methods From March 2005 to January 2009,forty-five patients diagnosed with EPII,who failed to improve with conventional conservative management including nasogastric tube decompression,were enrolled in this study.All patients were prospectively nonrandomized into nasointestinal tube group(n=23)or Octreotide group (n=22).The outcomes were compared between nasogastric tube,nasointestinal tube and Octreotide groups.Results All the forty-five patients with EPII refractory to conservative management with nasogastric decompression were treated successfully with the nasointestinal tube decompression or octreotide in 3-12days.Compared with the Octreotide group,the first passage of flatus was earlier[(4.7±1.9)d vs(6.7 ±1.6)d]and abdominal circumference recovered faster[(90.4±2.0)%vs(95.1±1.3)%]in the nasointestinal tube group(P＜0.05).But the volume of cumulative and daily gastrointestinal decompression were more in nasointestinal tube group than those in Octreotide group[(4037±1155)ml vs(3316±1038)ml;(890±181)mlvs(492±83)ml;P＜0.05].Conclusions Patients with EPII could be safely and effectively managed by nasointesfinal tube decompression or octreotide.It iS possible for those patients to avoid second laparotomy.Nasointestinal tube decompression and octreotide are associated with faster recovery and less fluid loss respectively.