Upper gastrointestinal contrast study in the management of small bowel obstruction--a prospective randomised study.

B T Fevang, D Jensen, J Fevang, K Søndenaa, K Ovrebø, O Røkke, H Gislasson, K Svanes, A Viste
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引用次数: 72

Abstract

Objective: To find out whether contrast radiography helps to resolve small bowel obstruction.

Design: Prospective randomised trial.

Setting: University hospital, Norway.

Subjects: 98 consecutive patients with symptoms of small bowel obstruction and a plain abdominal radiograph that confirmed the diagnosis.

Interventions: The patients were randomly allocated to receive a mixture of barium and sodium diatrizoate (Gastrografin) (n = 48) or not (n = 50). Both groups were followed up clinically and by repeated abdominal films.

Main outcome measures: Non-operative resolution of small bowel obstruction; number of patients with strangulated bowel; bowel resections; mortality; complications; hospital stay; and time from admission to operation.

Results: No significant differences were observed between the groups in the incidence of non-operative resolution (31/48 in contrast group, 35/50 in control group, OR: 0.89), strangulation obstruction (1/48 in contrast group, 4/50 in control group, OR: 0.24), bowel resection (3/48 in contrast group, 4/50 in control group, OR: 0.76), complications (8/48 in contrast group, 5/50 in control group, OR: 1.80), mortality (3/48 in contrast group, 1/50 in control group, OR: 3.26), and hospital stay (0-7 days: 34/48 in contrast group, 38/50 in control group, p = 0.95). The contrast group had a shorter interval between admission and operation than the control group (0-24 hours: 12/48 in contrast group, 3/50 in control group, p = 0.005).

Conclusion: The contrast examination did not contribute to the resolution of small bowel obstruction.

小肠梗阻治疗的上胃肠道对比研究——一项前瞻性随机研究。
目的:探讨造影是否有助于消除小肠梗阻。设计:前瞻性随机试验。地点:挪威大学医院。研究对象:连续98例有小肠梗阻症状并经腹部平片证实诊断的患者。干预措施:患者被随机分配接受钡和三角化钠混合治疗(n = 48)或不接受治疗(n = 50)。两组患者均接受临床随访和腹部重复影像检查。主要观察指标:小肠梗阻非手术解决;肠绞窄患者数;肠切除术;死亡率;并发症;住院;以及从入院到手术的时间。结果:两组间非手术消退发生率(对照组31/48,对照组35/50,OR: 0.89)、绞窄性梗阻发生率(对照组1/48,对照组4/50,OR: 0.24)、肠切除术发生率(对照组3/48,对照组4/50,OR: 0.76)、并发症发生率(对照组8/48,对照组5/50,OR: 1.80)、死亡率发生率(对照组3/48,对照组1/50,OR: 0.80)差异无统计学意义。3.26),住院时间(0-7天:对照组34/48,对照组38/50,p = 0.95)。对照组患者入院至手术时间间隔较对照组短(0 ~ 24 h:对照组12/48,对照组3/50,p = 0.005)。结论:造影检查对小肠梗阻的解决没有帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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