慢性假性肠梗阻110例临床治疗分析(1)
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[摘要] 目的：探讨慢性假性肠梗阻的最佳临床治疗方法。方法：对1995年6月~2011年1月在我院治疗的110例严重慢性假性肠梗阻患者进行回顾性分析，将其分为手术组(62例)和非手术组(48例)。手术组行盲肠造瘘、病变肠管切除手术，非手术组行保守治疗。通过对生存率、疾病复发、术后并发症和生活质量的分析来比较手术治疗与非手术治疗的治疗效果。结果：手术组患者预后在生存率、疾病复发及生活质量方面明显优于非手术组(RR死亡=0.49，P=0.02<0.05；RR复发=0.46，P=0.000 1<0.01；RR生活质量=0.52，P=0.000 1<0.01)。两组在并发感染方面比较，差异无统计学意义(RR并发感染=1.06，P=0.80>0.05)。结论：手术治疗严重慢性假性肠梗阻能有效改善患者预后。
[关键词] 假性肠梗阻；手术；预后
[中图分类号] R574.2 [文献标识码] B [文章编号] 1673-7210(2011)12(a)-190-02
Analysis on clinical treatment of 110 patients with chronic intestinal pseudoobstruction
SHI Jinsong
Department of General Surgery, the Center Hospital of Yiyang City, Hu'nan Province, Yiyang 413000, China
[Abstract] Objective: To study the best clinical treatment method of chronic intestinal pseudoobstruction (CIP). Methods: A retrospective study of 110 patients with serious CIP in our hospital from June 1995 to January 2011 was analysed. 110 patients were divided into surgery group (62 cases) and non-surgery group (48 cases). Surgery group were given surgical treatment such as colostomy and cutting lesion intestines. The data on death, recurrence, postoperative complications and quality of life of two groups were analyzed to compare the surgery and non-surgery methods. Results: The survival rate, disease recurrence, postoperative complication and quality of life of the surgery group were better than that of non-surgery group (RRdeath=0.49, P=0.02<0.05; RRrecurrence=0.46, P=0.000 1<0.01; RRquality of life=0.52, P=0.000 1<0.01). There was no significant difference between surgery group and non-surgery group in terms of complicated infection (RRinfectious diseases=1.06, P=0.80>0.05). Conclusion: Surgical treatment may be a good choice to improve the prognosis of patients with serious chronic intestinal pseudoobstruction.
[Key words] Intestinal pseudoobstruction; Surgery; Prognosis
慢性假性肠梗阻(chronic intestinal pseudo-obstruction，CIP)是一种没有机械性梗阻因素但具有肠梗阻症状，以胃肠道缺乏协调运输功能为特征的临床综合征[1]。慢性假性肠梗阻可分为原发性和继发性两类，原发性是由肠道平滑肌异常或肠神经系统异常造成，而继发性病因主要有结缔组织病、内分泌紊乱、帕金森病及EB病毒感染等[1]。慢性假性肠梗复发频繁，而且病情轻重个体间差异很大。目前的临床药物治疗诊疗慢性假性肠梗阻效果有限，而且病情严重的患者药效很差，往往需行胃肠减压、营养支持、盲肠造瘘、部分肠管切除等处理[2-3]。但目前对严重慢性假性肠梗阻患者是否采用早期手术探查治疗尚存在争议 ......
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