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Postoperative ileus (POI), one of the postoperative complications, not only
increases patient discomfort, slows patient recovery, prolongs hospital stay, wastes
medical resources, but also causes complications that can be life-threatening.
In this case, a 66-year-old woman presented to our emergency department
following a car accident. A liver laceration accompanied with hemoperitoneum
and multiple extremity fractures was found and Open Reduction Internal Fixation
surgery was performed smoothly. However, the absence of stool passage and
abdominal distention was observed in our intensive care unit the next day, with
radiologic confirmation, paralytic ileus was diagnosed.
Conservative therapy of nasogastric decompression with 33 days of peripheral
nutrition was administered. Eventually, she could tolerate the oral diet, but still had
constipation and severe abdominal distension, which affected her breathing and
made it difficult to extubate. Moreover, deterioration in the level of consciousness
was observed in the latter period, so her family sought the help of traditional Chinese
Medicine.
Diagnosed with qi deficiency and stagnation, addition of Xiang Sha Liu
Jun Zi Tang and acupuncture was prescribed. After twenty or so days of shared
TCM care, the patient not only digestion improved and consciousness clear, but
was extubated smoothly. Here are the medical records for one month providing a
reference of the treatment of postoperative ileus with Chinese medicine.
【Keywords】Postoperative ileus; POI; difficult extubation; Xiang Sha Liu Jun Zi
Tang; acupuncture
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254.7 術後麻痺性腸阻塞合併困難拔管：中醫會診病例報告
