Intestinal Obstruction during Pregnancy

懷孕時期的腸阻塞

張鈺堂(Yu-Tang Chang) ； 黃裕勝(Yu-Sheng Huang) ； 陳漢文(Hon-Man Chan) ； 黃哲人(Che-Jen Huang) ； 謝建勳(Jan-Sing Hsieh) ； 黃宗人(Tsung-Jen Huang)

《The Kaohsiung Journal of Medical Sciences》 22卷1期 (2006/01) Pp. 20-23

摘要

腸阻塞引起的腹部急症在懷孕時期並不常見，我們回顧並分析1984年6月到2002年12月在高雄醫學大學附設醫院外科住院的病患中，共有四位孕婦（年齡從22至35歲，平均28歲），因為腸阻塞接受手術治療。雖然只有三位病患曾經接受下腹部手術，腸粘連是這四人發生腸阻塞的共同原因，除其中一位因小腸扭轉缺血壞死須切除部分小腸外，其餘三人只需剝離腸粘連即可解除腸阻塞。兩位孕婦在子宮鬆弛劑的幫助下成功避免流產及早產。由於本研究的經驗，我們建議曾經接受腹部手術的孕婦一旦出現腸阻塞的症狀時，宜密切觀察和謹慎評估，必要時及早手術，以避免腸壞死。子宮鬆弛劑通常可以成功避免流產。

關鍵字

腸阻塞 ； 懷孕

並列摘要

Intestinal obstruction is a rare cause of acute abdominal pain during pregnancy. We reviewed and analyzed the medical records of four pregnant women with intestinal obstruction, treated at the Department of Surgery in the Kaohsiung Medical University Hospital during a period of 19 years, between June 1984 and December 2002. Their ages ranged from 22 to 35 years (mean, 28 yrs). Three cases had had prior lower abdominal surgery. Adhesion was the unique finding in all four patients during the operation. Enterolysis was needed to release the intestinal obstruction in three of the patients; the fourth required resection and anastomosis of the ileum as a result of volvulus. Premature labor was prevented with tocolysis in two patients. The results of this study lead us to emphasize the importance of close observation and early surgery to avoid intestinal strangulation if a pregnant woman who develops intestinal obstruction has an old surgical scar on her abdomen. Premature labor may be avoided with tocolysis.

並列關鍵字

intestinal obstruction ； ileus ； pregnancy