Integrative Treatment Of Early Postoperative Inflammatory Ileus Clinical Observation Of 30 Cases

Objective: Early postoperative inflammatory ileus (EPII) occurs in the early stage after abdominal surgery, mainly because bowel wall edema and exudation caused by trauma after abdominal surgery or intra-abdominal inflammation, which leads to the adhesive ileus both mechanically and dynamically. The majority of such patients could be cured by non-surgical therapy. Improper management often leads to unnecessary surgery, sometimes such severe complications as intestinal fistula, severe infection, short bowel syndrome could also occur. Therefore, correct understanding of such obstruction is of great significance. Nowadays, a number of scholars have believed that current conservative non-surgical treatment is the most effective method. We introduce the integrated treatment of the Compound Dachengqi Decoction (CDD) by means of nasogastric tube influx to observe its effect in treating EPII, which may promote the recovery of intestinal function and advance the relief of ileus. Meanwhile, we attempt to explore the relative mechanism of such management in the treatment of EPII.Materials and Methods: Retrospective analysis of fifty-eight patients who were diagnosed EPII since December 2005 to December 2007 was conducted. Patients were divided into two groups: 30 cases in the Integrated traditional and western medicine group (the Treatment Group) and 28 cases in the Western medicine group (the Control Group). The Treatment Group applied the CDD through nasogastric tube influx, combined with the conservative treatment of the Western medicine, while the Control Group adopted the Western medicine alone. Our study compared the recovery time of bowel sound, anus exhaust, also the time of complete disappearance of symptoms and the time of therapy in the two groups. Looser stools and cleaner liquid of gastrointestinal decompression were defined as mitigative indicators of the curative effect. Alleviation of symptoms, the change of the volume of gastrointestinal decompression and the efficiency were compared between the two groups.Results: After treatment, 41 of 58 patients (70.69%) were cured, 4 of 58 (6.90%) were effectual, 5 of 58 (8.62%) were effective, 8 of 58 (13.79%) was ineffective,the overall efficiency was 50 of 58 (86.21%). In the Treatment Group, 25 of 30 (83.33%) patients were cured, 2 of 30 (6.67%) were effectual, 2 of 30 (6.67%) were effective, 1 of 30 (3.33%) was ineffective. In the Control Group, 16 of 28 (57.14%) patients were cured, 2 of 28 (7.14%) were effectual, 3 of 28 (10.71%) were effective, 7 of 28 (25.0%) were ineffective. One case was turned to surgery and was cured by conservative treatment postoperatively. The total efficiency was 29 of 30 (96.67%) in the Treatment Group, which was significantly higher than 21 of 28 (75.0%) in the Control Group (p<0.05). Compared the recovery time of bowel sound, anus exhaust, the time of complete disappearance of symptoms and the time of therapy, the two groups were significantly different (p<0.05). As for the curative effect, the Treatment Group was better than the Control Group with significant difference (p<0.05). From the beginning of the hospitalization, patients in the two groups were all adopted continuing gastrointestinal decompression treatment, while CDD was applied through nasogastric tube influx in the Treatment Group. We found no significant difference in the change of the volume of gastrointestinal decompression compared with the two groups (p>0.05).Conclusions: Application of the Integrated traditional and western medicine of the CDD through nasogastric tube influx has obvious therapeutic effect in the treatment of EPII, which could profit the regression of the intra-abdominal inflammation and the absorption of the exudate, reduce the bowel wall edema gradually and promote the intestinal function. That could relieve the ileus, lower the incidence of complications and shorten hospitalization time. So we suggest it be an ideal management, especially for the patient of EPII with abdominal distension. The CDD has the effect of Tongli Gongxia, Liqi Zhitong, Huoxue Huayu, Ruanjian Sanjie and so on.In short, the curative effect of the CDD in treating EPII is positive. We are satisfied with the therapeutic efficacy of Integrated traditional and western medicine treatment. It is worthy of expansive usage.