Randomized clinical study of Gastrografin® administration in patients with adhesive small bowel obstruction
Randomized clinical study of Gastrografin® administration in patients with adhesive small bowel obstruction
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DOI：
10.1002/bjs.4150
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发表时间：
2003-05-01
影响因子：
9.6
通讯作者：
Jaurrieta, E
中科院分区：
文献类型：
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作者：
Biondo, S;Parés, D;Jaurrieta, E
背景：口服泛影葡胺（（R））已被用于区分部分性和完全性小肠梗阻（SBO）。它可能具有治疗效果，并预测需要早期手术治疗粘连性SBO。本研究的目的是确定是否在SBO的管理造影检查允许早期口服摄入量，并减少住院stay.Methods：83例患者2000年2月和2001年11月之间入院的90次症状和体征提示术后粘连SBO被随机分为两组，对照组和泛影葡胺（（R））组。对照组采用保守治疗。如果出现绞窄症状或梗阻在4-5天后未自行消退，则进行剖腹手术。Gastrografin（（R））组的患者接受100 ml Gastrografin（（R））。那些在24小时内造影剂到达结肠的人被认为是部分SBO，并口服。如果Gastrografin（（R））未能到达结肠，并且患者在接下来的24天内没有改善，则进行剖腹手术。结果：保守治疗成功77例（85.6%），13例（14.4%）需要手术。在保守治疗的患者中，泛影葡胺组的住院时间较短（P < 0.001）。所有造影剂到达结肠的患者均能耐受早期口服饮食。泛影葡胺（R）并没有减少手术的需要（P = 1.000）。结论：口服泛影葡胺（R）有助于粘连性SBO患者的管理，并缩短住院时间。
Background: Oral Gastrografin((R)) has been used to differentiate partial from complete small bowel obstruction (SBO). It may have a therapeutic effect and predict the need for early surgery in adhesive SBO. The aim of this study was to determine whether contrast examination in the management of SBO allows an early oral intake and reduces hospital stay.Methods: Eighty-three patients admitted between February 2000 and November 2001 with 90 episodes of symptoms and signs suggestive of postoperative adhesive SBO were randomized into two groups, a control group and Gastrografin((R)) group. Patients in the control group were treated conservatively. If symptoms of strangulation developed or the obstruction did not resolve spontaneously after 4-5 days, a laparotomy was performed. Patients in the Gastrografin((R)) group received 100 ml Gastrografin((R)). Those in whom the contrast medium reached the colon in 24 h were considered to have partial SBO, and were fed orally. If Gastrografin((R)) failed to reach the colon and the patient did not improve in the following 24 It a laparotomy was performed.Results: Conservative treatment was successful in 77 episodes (85.6 per cent) and 13 (14.4 per cent) required operation. Among patients treated conservatively, hospital stay was shorter in the Gastrografin((R)) group (P < 0.001). All patients in whom contrast medium reached the colon tolerated an early oral diet. Gastrografin((R)) did not reduce the need for operation (P = 1.000). No patient died in either group.Conclusion: Oral Gastrografin((R)) helps in the management of patients with adhesive SBO and allows a shorter hospital stay.