《中国康复理论与实践》

《中国康复理论与实践》 ›› 2015, Vol. 21 ›› Issue (08): 982-985.

• 特稿 • 上一篇    下一篇

脊髓损伤后粘连性肠梗阻35 例报道

龙志华，高飞，徐青   

  1. 1.首都医科大学康复医学院，北京市100068；2.中国康复研究中心北京博爱医院，北京市100068。作者简介：龙志华(1976-)，男，汉族，湖南安仁县人，硕士研究生，主治医师，主要研究主向：胃肠外科。通讯作者：徐青，主任医师，教授，硕士研究生导师。E-mail: tsingcrrc@sina.cn 。
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-08-25 发布日期:2015-08-25

Diagnosis and Surgical Treatment of Adhesive Intestinal Obstruction after Spinal Cord Injury: 35 Cases Report

LONG Zhi-hua, GAO Fei, XU Qing   

  1. 1.Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China; 2. Department of General Surgery, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-08-25 Online:2015-08-25

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摘要： 目的分析脊髓损伤患者腹部手术后粘连性肠梗阻的临床特点，总结临床诊治经验。方法对2008 年8 月~2013 年8月在本院普外科接受诊治的35 例脊髓损伤后粘连性肠梗阻患者的临床资料进行回顾性分析。结果35 例患者脊髓损伤后均因各种原因有过腹部手术史，结肠代膀胱术后22 例，胆囊切除术后13 例。其中胸10~腰1 段脊髓损伤25 例，颈段脊髓损伤10 例。26 例(74.3%)非手术治疗后痊愈，9 例(25.7%)行手术治疗。结论脊髓损伤患者腹部手术后发生肠梗阻后，临床症状和体征不典型，早期诊断较困难，需结合影像学检查，对于非手术治疗效果不明显时，应及时行剖腹探查。

关键词: 脊髓损伤, 粘连性肠梗阻, 神经源性肠道功能障碍

Abstract: Objective To analyze the clinical characteristics of spinal cord injury patients with postoperative adhesive intestinal obstruction, and summarize the clinical experience of diagnosis and treatment. Methods 35 spinal cord injury patients with postoperative adhesive intestinal obstruction in our department from August 2008 to August 2013 were reviewed. Results All of them had a history of abdominal surgery for various reasons, 22 cases received sigmoid colon pouch procedure and 13 cases received cholecystectomy. 25 cases suffered T10-L1 spinal cord injury, 10 cases suffered cervical spinal cord injury; 26 cases (74.3%) received non-operative treatment and recovered, 9 cases (25.7%) were transferred to surgery. Conclusion There is no typical clinical symptom and sign in spinal cord injury patients with adhesive intestinal obstruction after abdominal surgery, so early diagnosis is difficult, and the imaging examination is necessary. When non-operation treatment is not effective to these patients, surgical treatment should be timely carried out.

Key words: spinal cord injury, adhesive intestinal obstruction, neurogenic bowel dysfunction