清肠合剂保留灌治疗术后肠粘连的临床研究.pdfVIP

Abstract Objective : Through the clinical observation,we can research the curative effect of Qing Chang He Ji to cure the ankylenteron after surgical operation,besides,we can also approach the mechanism of action ot Qing Chang He Ji. Methods: 60 patients were divided into two groups:The treatment group(30 patients) and the control group(30 patients). The treatment group take the Qing Chang He Ji to enteroclysis on the basis of routine treatment while the control group take the treatment of relieving spasm and pain. To observe the situation of abdominal pain and distention and other symptoms. Results: Two groups of cases curative effect that no obvious differences and both methods are effective, but afterwards,there were outstanding differences in the situation of symptoms. The treatment group was clear better than the control group. Conclusion: This method offers a new way for the treatment of ankylenteron after surgical operation ,It is significant and applicable. Key words ankylenteron after surgical operation; enteroclysis; clinical observation 引 言 术后肠粘连是目前仍然困扰外科界的一个难题。主要表现为手术后腹部出现隐 痛，胀痛，攻窜痛，阵发性发作，肛门排气或排便后缓解，腹软，无反跳痛，可有局 限性压痛，无肠型及蠕动波，听诊肠鸣音活跃，无气过水声或金属音，腹部摄片可见 [1] 肠管胀气扩张，无阶梯状气液平面 。近年的研究报告指出，经历过腹部手术的病人 [2] [3] 90%~100%发生术后肠粘连 。发生粘连的病人中有超过50% 的病例涉及到小肠 。 1872年，Bryant首次报道1例术后肠粘连引起致命性肠梗阻的病人。此后，人们为了 防止术后肠粘连的发生进行了大量动物试验和临床研究，方法多样，作用不一。目前， 如何有效的消除病人症状以及尽早的恢复病人的肠道功能是外科医生重点关注的问 题。为了使患者尽早的恢复肠道功能，加快患者康复，减少患者身体上的病痛以及缓 解病人经济上的压力，我院依据古方，以中医理论为指导，结合中药药理，自制出“清 肠合剂”，对使用此合剂的术后肠粘连病人和未使用此合剂的同种病人进行临床研究 比较，观察肠道功能的恢复情况。本研究为中药灌肠治疗肠粘连提供了依据，证明中 药的灌肠使用方法是合理的，安全可靠的，同时大大拓宽了患者用药的客观条件，避 免了患者因各种原因无法口服中药的类似情况的产生，保证了治疗的连续性。在术后 肠粘连的治疗思路上无疑开辟了很好的途径。