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肠梗阻是什么病?它是如何被引发的?

科普中国微平台 2018-08-01

  本文专家:杨超,医学博士,火箭军总医院主治医师。

  本文审稿:陈海旭博士,副研究员,解放军总医院南楼临床部、老年疾病国家临床医学研究中心、老年医学研究所

  前些天有新闻报道称一小伙早上着急上班,在街边囫囵吞枣地吃下了3个茶叶蛋,次日凌晨开始腹痛、腹胀,疼痛难忍,就医后确诊为肠梗阻。最后经过手术才顺利康复。

  

  那么,这个肠梗阻究竟是个什么病,严重到得动手术才能治?它是如何被引发的?下面就一起来看看!

  什么是肠梗阻?

  肠梗阻是指部分或全部的肠内容物不能正常流动并顺利通过肠道,通俗地说就是肠子被堵住了,是常见的外科急腹症之一。肠梗阻病情多变,且发展迅速,严重时可能引发肠坏死、穿孔,危及生命!

  

  肠梗阻会有哪些症状?

  持续性腹部疼痛,急性梗阻的病人为绞榨性疼痛,如果合并炎症,常为持续性疼痛阵发性加剧,慢性梗阻的病人多为持续性的腹部钝痛。

  

  呕吐:肠梗阻患者呕吐多为反射性。

  腹胀:多在梗阻发生后晚期出现。

  

  排气、排便停止:肠道完全梗阻可造成排便停止,但如果是不完全梗阻,或是梗阻的早期,仍可有少量排气排便。

  引起肠梗阻的原因有哪些?

  肠管堵塞,比较少见,主要有粪块、寄生虫、异物等堵塞肠腔引起肠梗阻。比如前面说的吞了3个茶叶蛋的小伙,医生在他的小肠中取出了一个完整的蛋黄。

  

  肠管受压,如粘连带压迫和肠管扭转,嵌顿疝等。

  肠壁病变,如先天性肠道闭锁、肠套叠、克罗恩氏病、肠道肿瘤等。

  肠动力不足,如腹部大手术、肠道炎症及神经系统功能紊乱等。

  肠管血运障碍,具有肠系膜血管栓塞或血栓形成,导致血运性肠梗阻。

  如何预防肠梗阻?

  根据肠梗阻发生的原因,有针对性采取某些预防措施,可有效地防止、减少肠梗阻的发生。

  对患有腹壁疝的患者,应予以及时治疗,避免因嵌顿、绞窄造成肠梗阻。

  习惯性便秘者,应多活动、多饮水,必要时在医生指导下选用合适的药物,促进肠蠕动,帮助粪便软化,预防肠梗阻。

  

  加强卫生宣传、教育,养成良好的个人卫生习惯,预防和治疗肠蛔虫病。

  腹部大手术后及腹膜炎患者应进行胃肠减压,减轻或避免腹腔感染,术后应进行早期活动。

  40岁以上人群,定期做肠镜检查,早期发现和治疗肠道肿瘤。

  

  老人应多选择易消化、含纤维素多的食物,少食不易嚼烂、易形成团块的食物,谨防食源性肠梗阻。

  

  家长要加强对儿童的看护,避免儿童吞下异物。

  治疗其他原发病消化系统及心血管疾病是引起肠梗阻常见的原发病。

  温馨提示:如果发现腹痛持续加重,一定要排查肠梗阻可能性,避免误当成肠胃炎诊治,耽误了治疗手术的宝贵时间!

责任编辑:王超

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