Therapeutic Effect Of Dexamethasone On Early Postoperative Inflammatory Small Bowel Obstruction After Gastrointestinal Surgery

Objective:To observe the clinical efficacy and safety of dexamethasone in the treatment of early postoperative inflammatory small bowel obstruction after gastrointestinal tract surgery.Methods:The clinical data of 40 patients with early postoperative inflammatory small bowel obstruction who underwent gastrointestinal surgery admitted to the Department of Gastrointestinal Surgery of the Affiliated Hospital of Zun yi Medical Unversity from December 2013 to December 2017 were retrospectively analyzed.They wrere grouped according to differences in treatment methods: Dexamethasone group:(19 cases)treated with low-dose glucocorticoid combined with somatostatin;Non-dexamethasone group:(21cases)treated with somatostatin.The clinical symptoms after treatment were compared(recovering anal defecation exhaust time,abdominal pain relief time,abdominal distension relief time),somatostatin treatment time,restoring eating time,abdominal CT improvement time,etc;The conservative treatment relief in the two groups was compared;the two groups the clinical symptom relief rate of intestinal obstruction at 3days,7 days,and 10 days after treatment were compared;whether anastomotic leakage occurred after treatment in both groups.Results: The general data were compared between the two groups in terms of age,gender,BMI,previous abdominal surgery history,diabetes,etc.The general data were comparable between the two groups(P > 0.05);The dexamethasone group and the non-dexamethasone group recovered the anal defecation exhaust time after treatment were(6.37 ± 2.06)d and(8.33 ± 1.80)d,and the abdominal pain relief time were(5.53 ± 2.01)d and(6.68 ± 1.71)d,respectively.The remission time was(6.26 ± 2.56)d and(6.86 ± 1.71)d,and the treatment time of somatostatin was(5.26 ± 1.59)d and(7.14 ± 2.80)d,respectively.The recovery time was(5.26 ± 1.59)d and(10.24 ± 1.81)d,abdominal CT improvement time was(9.89 ± 2.25)d and(15.61 ± 2.87)d.After treatment,the remissiontime of the dexamethasone group was shorter time than the non-dexamethasone group,the difference was statistically significant(P < 0.05).The dexamethasone group was treated with dexamethasone for(6.21 ± 2.82)days,and the treatment time was slightly longer than that of dexamethasone group.The two groups received clinical remission after conservative treatment.The longest treatment time in the dexamethasone group was 12 days,and the longest treatment time in the non-dexamethasone group was 16 days.The remission rate of intestinal obstruction in the dexamethasone group and the non-dexamethasone group was 52.6%(10/19)and 19.0%(4/21),respectively(c2= 4.945,P = 0.03)after 3 days of treatment;the remission rate was 78.9% after 7 days of treatment(15/19)and 47.6%(10/21)(c2= 4.177,P = 0.04);the remission rates after 10 days of treatment were 94.7%(18/19)and 66.7%(14/21),respectively(c2= 4.912,P = 0.03).After conservative treatment,there was no anastomotic leakage in both groups.Conclusion: Low-dose dexamethasone combined with somatostatin in the treatment of early postoperative inflammatory small bowel obstruction after gastrointestinal surgery can quickly alleviate the clinical symptoms of intestinal obstruction,shorten the course of treatment,and does not increase the occurrence of anastomotic leakage.