Abstract: 【Abstract】〓Objective〓To assess the therapeutic value of perfusion of water-soluble contrast medium (Gastrografin ) in the management of adhesive small bowel obstruction. Methods〓Patients with clinical evidence of adhesive small bowel obstruction were performed conservative treatment unless there was suspicion of perforation,.strangulation and peritonitis which needed emergency operation. Fifty-seven cases were divided into the treatment group and the control group. The controls received normal conventional treatment, mainly including fasting, gastrointestinal decompression, enema, intravenous fluid infusion. And those in treatment group were treated with 60-100 ml Gastrografin perfusion either orally or via nasogastric tube, in addition to normal conventional treatment. The effect of non-surgical treatment, relief time of obstruction, length of hospitalization, and complications of two groups were compared between. Results〓For the patients in the treatment group, the effect of non-surgical treatment was significantly better than that in the control group (83.3% VS 55.6%). The results of treatment group in time of bowel tunes recovery (9.56±3.47 h), anal exhaust time (11.24±3.15 h) and the length of hospitalization (5.0±1.83 d) were superior to that of control group (9.56±3.47 h, 22.6±4.14, 8.20±2.15 d, respectively). The daily amount of gastrointestinal decompression in treatment group was 179.20±68.79 ml and control group 323.33±91.31 ml. There was no severe complications in both groups. Conclusion〓In our study, Gastrografin showed effective, safe outcomes for the management of adhesive small bowel obstruction.

Key words: Small bowel obstruction, Adhesive, treatment, Water-soluble contrast medium, Gastrografin

摘要： 【摘要】 目的 探讨水溶性造影剂(泛影葡胺)在粘连性小肠梗阻治疗中的价值。方法〓明确诊断为小肠梗阻的患者,不合并肠穿孔、腹膜炎及绞窄性肠梗阻等需要急诊手术的情况。采用前瞻性研究方法,将入组的57例患者分为2组:对照组与治疗组。对照组给予常规治疗,如禁食、胃肠减压、灌肠、静脉补液等;治疗组除常规保守治疗方法外,患者口服或均经胃肠减压管注入76%泛影葡胺60~100 mL并夹管1小时,观察两组非手术治疗的有效率、小肠梗阻缓解时间、住院时间以及并发症的发生情况。结果〓应用泛影葡胺的治疗组非手术治疗的有效率明显高于对照组(83.3% VS 55.6%),差异有统计学意义;非手术治疗有效的两组患者中,治疗组患者在肠鸣音恢复时间9.56±3.47 h VS 19.67±3.90 h)、肛门排气时间(11.24±3.15 h VS 22.6±4.14 h)、每日胃肠减压量(179.20±68.79 mL VS 323.33±91.31 mL)、住院时间(5.0±1.83 d VS 8.20±2.15 d)均明显小于对照组,各指标间的比较均有显著性差异。两组均未出现严重并发症。结论〓泛影葡胺治疗小肠梗阻疗效确切,值得推广应用。

关键词: 小肠梗阻, 粘连性, 治疗, 水溶性造影剂, 泛影葡胺