胃肠术后炎性肠梗阻患者的保守治疗体会(2)
需要指出，主张保守治疗并不是绝对不手术，对于术后早期肠梗阻应区别对待。虽然炎性肠梗阻首选保守治疗，但当患者出现体温持续上升，白细胞升高，腹痛腹胀加重，明显的腹膜刺激症状，或怀疑有绞窄性肠梗阻发生时，应及时中转手术。
总之，炎性肠梗阻是腹部手术后较严重的并发症，增加了患者痛苦，延长了住院时间，加重了患者的经济负担。所以笔者认为临床医师要高度重视腹部手术，在手术操作过程中注意保护肠管，术中尽量减少创伤，严密止血，术毕用大量温生理盐水反复冲洗腹腔并吸尽积液，保持通畅的引流等措施可能会减少炎性肠梗阻的发生。
参考文献
[1] Pickleman J ,Lee RM. The management of patients with suspectedearly postoperative small bowelobstruction[J]. Ann Surg ,2009 ,212(1) :2165.
[2] Bondarenko NM ,Perets IV ,Bondarenko IN. The immediate resultsof treating patients with acute early postoperative intestinalob2struction[J]. Klin Khir ,2003 , (4) ;20.
[3]Zausig Y A, Weigand M A, Graf B M. Perioperative fluid management: An analysis of the present situation[J]. Anaesthesist, 2006, 55(4):371～390.
[4]Bozzetti F,Braga M,Gianotti L,et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomized multicenter trial[J]. Lancet, 2001,358(9292):1487～1492.
[5] Ward N. Nutrition support to patients undergoing gastrointestinal surgery[J]. Nutr J, 2003,2(18):1～5.
[6]Douglas W, Wilmore M D. From Cuthbertson to fasttrack surgery: 70 years of progress in reducing stress in surgical patients [J]. Ann Surg， 2002, 236(5)：643～648.
[7] 黎介寿. 认识术后早期炎性肠梗阻的特性[J]. 中国实用外科杂志,2008 ,18 (7) :3872～3874.
[8] 尹路,黎介寿,李宁,等. 腹部手术后早期炎性肠梗阻的处理[J]. 南京大学学报(自然科学版) ,2007 ，33 (1) :324 ., 百拇医药(彭华荣)
总之，炎性肠梗阻是腹部手术后较严重的并发症，增加了患者痛苦，延长了住院时间，加重了患者的经济负担。所以笔者认为临床医师要高度重视腹部手术，在手术操作过程中注意保护肠管，术中尽量减少创伤，严密止血，术毕用大量温生理盐水反复冲洗腹腔并吸尽积液，保持通畅的引流等措施可能会减少炎性肠梗阻的发生。
参考文献
[1] Pickleman J ,Lee RM. The management of patients with suspectedearly postoperative small bowelobstruction[J]. Ann Surg ,2009 ,212(1) :2165.
[2] Bondarenko NM ,Perets IV ,Bondarenko IN. The immediate resultsof treating patients with acute early postoperative intestinalob2struction[J]. Klin Khir ,2003 , (4) ;20.
[3]Zausig Y A, Weigand M A, Graf B M. Perioperative fluid management: An analysis of the present situation[J]. Anaesthesist, 2006, 55(4):371～390.
[4]Bozzetti F,Braga M,Gianotti L,et al. Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomized multicenter trial[J]. Lancet, 2001,358(9292):1487～1492.
[5] Ward N. Nutrition support to patients undergoing gastrointestinal surgery[J]. Nutr J, 2003,2(18):1～5.
[6]Douglas W, Wilmore M D. From Cuthbertson to fasttrack surgery: 70 years of progress in reducing stress in surgical patients [J]. Ann Surg， 2002, 236(5)：643～648.
[7] 黎介寿. 认识术后早期炎性肠梗阻的特性[J]. 中国实用外科杂志,2008 ,18 (7) :3872～3874.
[8] 尹路,黎介寿,李宁,等. 腹部手术后早期炎性肠梗阻的处理[J]. 南京大学学报(自然科学版) ,2007 ，33 (1) :324 ., 百拇医药(彭华荣)