Treatment of acute intestinal obstruction complicated with septic shock with Dachengqi decoction and Fusu agent
10.3969/j.issn.1008-9691.2024.03.018
- VernacularTitle:大承气汤联合复苏合剂加减救治急性肠梗阻合并脓毒性休克的治疗体会
- Author:
Peng DING
1
;
Yuan ZHOU
;
Xiujuan ZHOU
;
Song ZHANG
;
Peiyang GAO
Author Information
1. 成都中医药大学附属医院重症医学科,四川成都 610072
- Keywords:
Acute intestinal obstruction;
Septic shock;
Dachengqi decoction;
Fusu agent;
Abdominal distension;
Intra-abdominal hypertension
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(3):342-345
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the causes of acute intestinal obstruction after intracerebral hemorrhage,and the therapeutic effect of rectal dripping with Dachengqi decoction and Fusu agent on acute intestinal obstruction complicated with septic shock.Methods The clinical data of a patient with acute intestinal obstruction complicated with septic shock after intracerebral hemorrhage,who was admitted to the Hospital of Chengdu University of Traditional Chinese Medicine(TCM)on March 5,2022,were retrospectively analyzed.The study aimed to observe the effects of rectal dripping with TCM on the recovery of intestinal function and improvement of shock.Results The patient was a 52-year-old male who underwent"left temporal craniotomy intracranial decompression,craniocerebral hematoma removal,cerebrospinal fluid leak repair"on February 19,2022 due to cerebral hemorrhage.On the 7th day after operation,the patient had hiccups and abdominal distension,and after treatment,the patient developed fever,consciousness disorders,hypotension and other symptoms.Abdominal CT showed extensive intestinal fluid,gas and expansion.Hemodynamic monitoring indicated high discharge and low resistance,intra-abdominal pressure was 21 cmH2O(1 cmH2O≈0.098 kPa),and laboratory examination showed increased inflammatory indexes and abnormal biochemical indexes.The western medicine diagnosis was acute intestinal obstruction complicated with septic shock,and the symptomatic treatments such as organ support(lung,circulation,kidney),anti-infection,fluid resuscitation,analgesia and sedation were given.The TCM diagnosis was intestinal knot(yangming visceral substantive,sudden collapse of yang-qi),with treatment principles focusing on tongfu heat relief,wenshen qianyang,Dachengqi decoction and Fusu agent was added and reduced according to the syndrome differentiation,with medications administered rectally.After the use of TCM decoction,the patient's defecation volume increased significantly,the intra-abdominal pressure decreased to the normal range,abdominal distension was significantly reduced,and the shock was relieved.On the 17th day after the operation,the patient's symptoms improved,the respiratory cycle was stable,and the patient was successfully transferred out of intensive care unit(ICU).Conclusion The treatment of acute intestinal obstruction complicated with septic shock by rectal dripping with Dachengqi decoction and Fusu agent can quickly relieve the condition and promote the recovery of intestinal function.
