Obstruction of knowledge

Intestinal obstruction is a common surgical acute disease. Condition critical, complex and changeable.
(1) classification
According to the causes intestinal obstruction classification
① mechanical intestinal obstruction: more common. Because organic intestinal lesions lead to smaller, In intestinal contents through obstacles. Worm disease because its mission, foreign body blockage of stones and plastic, intestine reversed, incarcerated in Herniography neck, with oppression and involve adhesion, and tumor mass and other intra-abdominal pressure so that the lumen; or tumor, invagination, inflammatory lesions caused by the intestinal wall.
② impetus ileus: a result of nerve or toxin to inhibit peristalsis loss or intestinal cramps, intestinal contents so that the operation ceased, and there is no mechanical obstruction.
③ revascularization ileus: rare is the result of mesenteric vascular thrombosis or embolism, a blood supply to intestinal barrier and lose momentum.
There obstacles classification by blood supply
① simple intestinal obstruction: only through the contents of disruption, and there is no blood supply intestinal barrier.
⑨ strangulating intestinal obstruction: can mesenteric vascular thrombosis, embolization or compression corresponding acute ischemia; or simple intestinal obstruction due to a high degree of swelling, vascular compression of small intestine, and intestinal wall in blood lead Win obstacles.
According to the site of obstruction classification
① high of small bowel obstruction - air obstruction.
② low of small bowel obstruction - to intestinal obstruction.
③ colonic obstruction.
(2) clinical performance
Abdominal pain: for the performance of mechanical intestinal obstruction paroxysmal abdominal colic, which is due to overcome obstacles and intestine caused by the creeping increase, abdominal pain can attack with. If the period of intermittent abdominal pain continuously shortened, or even become a persistent abdominal pain, may be strangulating intestinal obstruction performance.
Vomiting: Early intestinal obstruction, was vomiting reflex, out of the food or gastric juice; general, the higher the site obstruction, vomiting appeared sooner, the more frequent, and low junction obstruction and intestinal obstruction, vomiting and later appeared less out of can a fecal sample.
Abdominal distention: there late. High abdominal distension not obvious obstruction, obstruction low abdominal distension and colonic obstruction was obvious.
Exhaust anal stop defecation: Complete obstruction occurred after patients do not exhaust defecation. However, a small number of patients still remaining in the obstruction following stool and gas, can still be discharged, it should not negate the presence of intestinal obstruction.
A general physical examination of acute pain looks, the general signs of early life little changed. Late in body temperature can be increased, shortness of breath, blood pressure decreased by fast pulse performance.
There will be signs of abdominal intestinal type, peristaltic waves, abdominal tenderness there, there can be a strangulating anti-and muscle tension. Some patients can be touched abdominal mass. Strangulating intestinal obstruction, there will be the ascites,can hear mobility voiced. Auscultation: mechanical intestinal obstruction, there will be Music hyperthyroidism and gas off the water sound. Strangulating intestinal obstruction Music weaken or disappear.
(3) physical and chemical inspection
Blood: Blood generally increased leukocyte count in 10 × 1O9 / L and above, often strangulating intestinal obstruction in 15 × 109 / L, neutrophils increased.
Determination of serum carbon dioxide combining power: When a metabolic acidosis, the combination of carbon dioxide can be reduced.
Determination of serum electrolytes: there will be the hypokalemia, low chlorine and hyponatremia.
X-ray examination: Perspective standing position that a number of liquid gas and flatulence plane intestinal loop.
(4) Treatment
Western medicine treatment
① non-surgical treatment: solution is water, electrolyte and acid-base balance disorders imbalance.
Gastrointestinal decompression: treatment of intestinal obstruction is one of the important ways, through the gastrointestinal decompression gastrointestinal absorption of gases and liquids, reduce abdominal distention, lower pressure within the lumen, reducing bacteria and toxins is conducive to improving the local and systemic situation.
Infection control: Application of antibiotics, the prevention and treatment of bacterial infections have important significance.
② surgical treatment: the various types of strangulating intestinal obstruction, congenital malformations and tumors caused by the obstruction, as well as non-surgical treatment should be held invalid surgical treatment of patients, surgical methods should be based on specific obstruction causes, nature, location and systemic conditions.
Chinese medicine treatment
Single-prescription
Health vegetable oil: Health and soybean oil, sesame oil or peanut oil, adult 200-250 ml, children 80-150 ml, oral or gastric tube injection.
(5) Nursing
Fasting water, gastrointestinal decompression to relieve abdominal distention. Election semi - supine posture to ease the pressure on the diaphragm. Close observation conditions change, if her illness became more serious. Vigilance should be the strangulating intestinal obstruction occurred, timely surgical treatment.
(6) prevention
The adhesive intestinal obstruction in remission should pay attention to diet, not to eat hard food, catering to dilute oriented. Ease of roundworm intestinal obstruction after insecticide treatment should be held, with the exception of drugs, insecticide can be used oxygen therapy dispel intestinal roundworm. After not eat three square meals a fierce campaign to prevent the occurrence of volvulus.