Intestinal obstruction is a group of clinical syndromes caused by different etiologies in which the intestinal contents cannot pass through the intestine normally. It can not only change the function of the intestine, but also disrupt the physiological function of the whole body.
I. Main causes
(a) Mechanical obstruction is the most common, accounting for about 90% or more.
1.Intestinal wall lesion: triggered by congenital intestinal stenosis, atresia, tumor, inflammation, etc.
2, intestinal tube compression: caused by intestinal torsion, intestinal adhesions, incarcerated hernia, etc.
3, intestinal lumen blockage: such as fecal mass, parasitic worm eggs, foreign bodies, etc.
(II) Dynamic intestinal obstruction is less common, mostly due to the dysfunction of intestinal wall muscles caused by neural reflexes or toxin stimulation, so that intestinal peristalsis is weakened or disappeared and the intestinal tube is spasmed, so that the intestinal contents stop running.
(c) Hemodynamic intestinal obstruction is mostly due to the formation of mesenteric vascular thrombosis or blockage, resulting in the obstruction of intestinal blood flow and loss of peristaltic force.
Intestinal obstruction can also be divided into simple, strangulated, high, low, complete and incomplete intestinal obstruction.
II. Judgment
The condition is often determined according to the following points.
(a) Determine whether intestinal obstruction exists according to the four major symptoms of abdominal pain, vomiting, abdominal distension, and no defecation without exhaustion from the anus. Together with the visible intestinal peristaltic waves or intestinal shape in the abdomen and hyperactive bowel sounds, the diagnosis can generally be made.
(B) How to distinguish the types of intestinal obstruction mechanical intestinal obstruction has typical paroxysmal abdominal colic, violent vomiting, abdominal distension, and stopping defecation and exhaustion from the anus.
1.Powered intestinal obstruction: no paroxysmal colic and hyperactive intestinal peristalsis. Intestinal peristalsis is weakened or disappeared, and abdominal distension is obvious.
2, strangulated intestinal obstruction: abdominal pain attack is rapid, with persistent aggravation, rapid onset, rapid change of condition, early signs of shock; vomiting blood, blood in stool, vomit is bloody or coffee-like; abdominal distension is uneven and masses can be found.
Third, first aid
After the occurrence of intestinal obstruction, it will lead to a series of pathological changes in the body. Due to the large amount of vomiting, it is impossible to eat, which leads to the decrease of blood volume and blood concentration. Acid metabolites increase, causing metabolic acidosis. The accumulation of intestinal contents and bacterial multiplication produce a large amount of toxins, which are absorbed by the organism and cause systemic toxic symptoms, easily leading to shock. The prognosis is poor and early surgery is required.
The general principles are to relieve intestinal obstruction, correct water-electrolyte and acid-base balance imbalance, and prevent and treat infection.
1.Early simple and incomplete intestinal obstruction with good general condition, mild symptoms and no obvious peritoneal irritation piece, non-surgical treatment is adopted.
① Make the patient lie still and comfort the patient to eliminate the tension.
②Fasten the diet.
③Analgesic sedation, dermal* injection of atropine 0,5mg; or Dulcolax 50-100mg intramuscular injection, repeat 1 injection after 6 hours if necessary.
④Gastrointestinal decompression is the key to treat intestinal obstruction, which can suck out intestinal fluid and gas and reduce intestinal lumen pressure, one with single-lumen gastric tube and one with double-lumen m-a tube to exclude bacteria and toxins.
⑤ Chinese medicine treatment has some auxiliary effect on intestinal obstruction, such as compound Da Cheng Qi Tang and Ascaris Cheng Qi Tang.
⑥Acupuncture or hand-guided acupuncture points such as Zhonggui, Tianshu, Fusanli, Hegu, Guanyuan and Qihai.
2, no matter which type of intestinal obstruction, quickly sent to the hospital for emergency treatment as the best policy, especially in the out-of-hospital first aid is ineffective and the condition continues to deteriorate, should be sent to the hospital quickly in every second.