| Background: Intestinal obstruction refers to the common surgical acute abdomen,which is referred to as the obstruction of the contents of the intestinal tract.,meanwhile,intestinal obstruction is a common complication after abdominal surgery.Clinical gastrointestinal malignant tumor postoperative intestinal obstruction etiolog y is relatively complex.Firstly,gastrointestinal malignant tumor surgery often cause bowel adhesion and stenosis in intestinal obstruction;Secondly,malignant tumor in gastrointestinal tract also can appear malignant tumor recurrence after surgery,it can lead to jams、 placeholder、 oppression insufflate also performance for the intestinal obstruction.Clinically,the neoplastic intestinal obstruction is easy to be neglected before it progresses to complete obstruction,and conservative treatment is adopted in clini cal practice.However,when the obstruction occurs repeatedly or progresses to complete obstruction,the general condition is poor,the operation tolerance is low,and the operation cannot achieve satisfactory results.So this type of intestinal obstruction in patients with clinical it is very difficult to handle.At present,there is no consensus on the treatment of such intestinal obstruction,and the clinical data is lacking.According to the symptoms of intestinal obstruction,the symptoms of TCM can be attributed to: "abdominal distension","abdominal pain"," obstruction and rejection"," accumulation" and so on."The use of the inner parts is to pass through",At present,the tradi tional Chinese medicine for diarrhea based on Da-Cheng-Qi decoction has been widely used in the clinical treatment of intestinal obstruction.Objective: To explore the causes,imaging factors,clinical features,combined treatment and diagnosis of intestin al obstruction after gastrointestinal malignancy;To provide reference for the diagnosis and treatment of intestinal obstruction after gastrointestinal malignancy.Methods: 81 patients with intestinal obstruction after gastrointestinal malignancies were divided into tumor recurrence group and non-recurrence group according to the etiology;according to whether or not the purgative Chinese medicine was divided into the TCM and western medicine combined group and the control group.To analyze the etiology,in fluencing factors,clinical features,diagnosis and treatment of integrated Chinese and Western medicine in patients with intestinal obstruction after gastrointestinal cancer.Results:(1)Among the 81 patients with gastrointestinal malignant tumor,53(65.4%)were male,28(34.6%)were female,The ratio of male to female is 1.89:1,the average age was between 41 and 91 years old,the average age is 65 plus or minus 10.09 years.(2)Patients with intestinal obstruction after gastrointestinal malignancy were divided into 2 groups,tumor recurrence group(31 cases)and non-recurrent group(50 cases).There were 41 cases(50.6%)in the stomach of 81 patients with primary malignant tumor;There was no statistical difference between the tumor recurrence group and the non-recurrent group in the primary tumor site(P>0.05).Tumor recurrence and no recurrence group in primary malignant tumor pathological differentiation and TNM staging with statistical difference(P<0.05).the primary tumor differentiation degree is poorer,TNM staging Ⅲ,Ⅳ period,multiple recurrent intestinal obstruction.There were 42 patients(51.9%)of the 81 patients with primary malignant tumor operation for more than 1 year;Compari son and analysis of surgical time between tumor recurrence group and non-recurrent group in the postoperative intestinal obstruction: There was no significant difference between the two groups within 1 year after surgery(P>0.05);The incidence of intestinal obstruction in tumor recurrence group was more than 1 year(P<0.05).(3)81 cases of gastrointestinal tract malignant tumor patients with postoperative ileus,clinical manifestations,or see a doctor when presented with mainly abdominal pain,abdominal distension or complete or incomplete stop defecation anus more than the num ber of cases of patients with common;In the area of clinical obstruction and type,small intestinal obstruction and complete obstruction accounted for the majority.There was no statistically significant difference between the tumor recurrence group and t he non-recurrent group(P>0.05),In the type of obstruction,the comparison between the two groups(P<0.05),the tumor recurrence group was more common than that in the non-recurrent group of intestinal obstruction.Compared with the non-recurrent group(P<0.05),the incidence of intestinal obstruction CEA in tumor recurrence group was significantly higher than that in non-recurrent group,there was no significant difference between AFP,CA125 and CA19-9(P>0.05).(4)Among the 81 cases of intestinal obstruction,there were 29 surgical treatment and 52 cases of non-surgical treatmen;Among the 52 patients treated with non-surgical treatment,34 were used in Chinese medicine,The patients in the combination group of Chinese and western medicine had less time of intestinal obstruction and the time of discharge and defecation than the control group(P<0.05).Conclusion:(1)There are many causes of intestinal obstruction after gastrointestinal malignancy,and the first and second place in this study is the adhesion of tumor and intestinal canal,and the non-neoplastic factors are more than the obstruction caused by neoplastic factors.(2)Clinically preliminary identification of recurrent and non-recurrent intestinal obstruction requires comprehensive factors.For from the primary gastrointestinal malignant tumor operation time more than 1 year 、 Primary tumor differentiation degree is poor 、 TNM staging Ⅲ,Ⅳ period 、 incomplete intestinal obstruction、 CEA index is positive,in accordance with the above several conditions to highly consider the possibility of gastrointestinal malignant tumor recurrence.(3)Gastrointestinal malignant postoperative ileus adopted more conservative treatment,western medicine based on adjuvant treatment of gastrointestinal malignant tumor postoperative intestinal obstruction combined with traditional Chinese medicine has significant advantages,can effectively shorten the patient’s recovery time and hospital stay,worth clinical promotion. |
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