摘要
目的 探讨肾移植术后小肠梗阻的诊断和治疗。方法 收集和分析6例肾移植术后小肠梗阻的病例资料。结果 6例患者出现肠梗阻症状的时间为肾移植术后0.5～46个月。4例在肾移植手术前后有腹部手术史。腹痛、腹胀和肛门停止排气、排便为主要临床表现。腹部X线明确诊断后,2例予禁食、胃肠减压等非手术治疗症状缓解;但其中1例缓解后发作急性排斥反应,予甲基强的松龙(MP)冲击治疗后好转。4例在非手术治疗无效后行手术治疗,分别行小肠粘连松解、粘连部分空肠切除术、端端吻合术和回肠部分切除术、端端吻合术,3例患者肠梗阻症状消失,1例术后死于腹腔感染。结论 早期诊断和正确及时的处理是改善肾移植术后小肠梗阻预后的关键。
Objective To investigate the diagnosis and treatment of small bowel ileus after kidney transplantation. Methods Clinical data of 6 cases with small bowel ileus after kidney transplantation from Jan. 1992 to Nov. 2002 were collected and analyzed retrospectively. Results All cases were diagnosed definitely and treated immediately with non-surgical methods such as fast and gastric suction. Two patients recovered and four had to undergo surgical operation because of ineffective non-surgical treatment, and lysis of adhesion or jejunectomy and jejunojejunostomy were performed. Three cases recovered after surgical treatment and one died of intra-abdominal infection. Acute rejection was observed in one case and was regressed after the methylprednisolone(MP) therapy. Conclusion The early diagnosis and correct treatment are the keys to improve prognosis of the small bowel ileus after kidney transplantation.
出处
《中华胃肠外科杂志》
CAS
2003年第6期400-401,共2页
Chinese Journal of Gastrointestinal Surgery
