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目的分析剖宫产术后并发急性结肠假性梗阻临床特点,为临床进一步诊断治疗提供帮助。方法回顾性分析14例剖宫产术后并发急性结肠假性梗阻患者的临床表现、治疗方式和治疗结果等临床资料。结果 14例患者肠梗阻发作时间为剖宫产术后2～5 d,均有机械性肠梗阻的临床表现,主要以进行性腹胀为主要特点,较少剧烈腹痛,极少有肠坏死和穿孔并发症。11例患者经胃肠减压、禁食水、生长抑素静注和灌肠等保守治疗治愈,3例保守治疗效果欠佳,经结肠镜减压后痊愈,无死亡病例。结论剖宫产术后急性结肠假性梗阻绝大多数为功能性梗阻,可通过保守治疗和结肠镜减压等非手术方法治愈,预后良好,应与器质性结肠梗阻相鉴别,避免不必要的剖腹探查。
Objective To analyze the clinical features of acute colonic pseudobulbar occlusion after cesarean section and to provide help for clinical further diagnosis and treatment. Methods Retrospective analysis of clinical data of 14 cases with cesarean section complicated with acute colonic false obstruction, clinical data, treatment methods and treatment results. Results The onset time of intestinal obstruction in 14 patients was 2 ~ 5 days after cesarean section. All of them had the clinical manifestations of mechanical intestinal obstruction. The main features were progressive abdominal distension, less severe abdominal pain, minimal intestinal necrosis and perforation complication. Eleven patients were cured by conservative treatment including gastrointestinal decompression, fasting water, somatostatin infusion and enema. Three patients were ineffective in conservative treatment and were cured after decompression by colonoscopy without any deaths. Conclusion The majority of acute colonic pseudo-obstruction after cesarean section is functional obstruction, which can be cured by non-operative methods such as conservative treatment and colonoscopic decompression. The prognosis is good and should be distinguished from organic colonic obstruction to avoid unnecessary Laparotomy.