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目的探讨小儿急性阑尾炎术后早期炎性肠梗阻的临床特点、诊治方法及预防措施。方法对我院2001年1月～2008年1月,8年间共26例小儿急性阑尾炎术后早期炎性肠梗阻患儿的诊治经验进行研究分析。治疗方法包括禁食、胃肠减压、全肠外营养、抗炎、糖皮质激素及中药的应用。结果24例保守治疗成功,平均治疗时间约10天,中转手术2例,无肠坏死,最终也治愈出院。结论小儿术后早期炎性肠梗阻的特点有:(1)多数于术后7天左右出现肠梗阻症状,多由腹腔内炎症所致广泛肠粘连引起;(2)症状以腹胀为主,腹痛相对较轻,较少发生肠绞窄;(3)治疗应首选保守治疗。
Objective To investigate the clinical features, diagnosis and treatment methods and preventive measures of early postoperative inflammatory intestinal obstruction in children with acute appendicitis. Methods A total of 26 children with acute inflammatory appendicitis after operation in our hospital from January 2001 to January 2008 were retrospectively analyzed. Treatment includes fasting, gastrointestinal decompression, total parenteral nutrition, anti-inflammatory, glucocorticoid and traditional Chinese medicine. Results 24 cases of conservative treatment success, the average treatment time of about 10 days, 2 cases of transit surgery, no intestinal necrosis, and ultimately cured and discharged. Conclusions Early postoperative inflammatory intestinal obstruction in children are characterized by: (1) most of the symptoms of intestinal obstruction appear about 7 days after surgery, mostly caused by extensive intestinal adhesions caused by intraperitoneal inflammation; (2) the symptoms of abdominal distension, abdominal pain Relatively lighter, less incidence of intestinal strangulation; (3) treatment should be the preferred conservative treatment.