腹腔镜与开腹十二指肠环形引流术的临床对比研究  

Comparison of laparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome

作　　者：郭琳[1] 刘兴[1] 孙威[1] 

机构地区：[1]中国医科大学附属盛京医院胃肠营养外科,沈阳110004

出　　处：《中国普外基础与临床杂志》2017年第2期210-214,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的对比分析腹腔镜与开腹十二指肠环形引流术治疗肠系膜上动脉压迫综合征的手术效果。方法回顾性分析2012年12月至2015年12月期间我院手术治疗的肠系膜上动脉压迫综合征患者51例,其中行开腹十二指肠环形引流术28例(开腹组),行腹腔镜十二指肠环形引流术23例(腹腔镜组)。比较2组患者的手术时间、术中出血量、术后下床活动时间、术后止痛药物使用情况、术后首次排气时间、术后首次进食时间、术后住院时间以及术后并发症发生情况。结果腹腔镜组和开腹组患者的年龄、性别及体质量指数比较差异无统计学意义(P>0.05)。腹腔镜组和开腹组间的手术时间比较差异无统计学意义(P>0.05),腹腔镜组的术中出血量明显少于开腹组(P<0.05)。腹腔镜组术后的下床活动时间、首次肛门排气时间、首次进食时间及住院时间均明显短于开腹组(P<0.05),并且腹腔镜组术后的止痛药物使用率也明显低于开腹组(P<0.05)。腹腔镜组的切口感染率、肺部感染率及肠梗阻发生率明显低于开腹组(P<0.05),而2组间吻合口漏及吻合口出血的发生率比较差异无统计学意义(P>0.05)。2组间总并发症发生率比较差异无统计学意义(P>0.05)。所有患者经8~36个月随访,患者临床症状均消失,体重增至正常水平。结论从本研究的初步研究结果来看,腹腔镜十二指肠环形引流术具有创伤小、恢复快、并发症少、住院时间短等优点,可作为治疗肠系膜上动脉压迫综合征的理想选择。Objective To compare efficacy oflaparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome （SMACS）. Methods From December 2012 to December 2015, the clinical data of 23 cases of laparoscopic duodenal circular drainage operation （laparoscope group） and 28 cases of open duodenal circular drainage operation （open group） were analyzed. The operation time, intraoperative bleeding, postoperative ambulation time, postoperative analgesics usage, postoperative the first exhaust time, postoperative the first feeding time, postoperative hospitalization time and postoperative incidence of complications were compared. The patients were followed up to confirm the effect after the operation. Results There were no differences of the age, sex, and body weight index between the laparoscope group and the open group （P〉0.05）. The operation time had no significant difference between these two groups （P〉0.05）. Compared with the open group, the intraoperative bleeding was less （P〈0.05）, the postoperative ambulation time, postoperative the first exhaust time, postoperative the first feeding time, postoperative hospitalization time were shorter （P〈0.05）, the rates of postoperative analgesics usage, incision infection, pulmonary infection, and intestinal obstruction were lower （P〈0.05） in the laparoscope group. The rates of anastomotic leakage and anastomotic bleeding, and total postoperative complications rate had no significant differences between these two groups （P〉0.05）. All the patients were followed up for 8-36 months. The clinical symptoms disappeared and the body weight increased to normal level in the two groups. Conclusions Preliminary results of in this study show that laparoscopic duodenal circular drainage operation in treatment of SMACS has some advantages such as less trauma, faster recovery, fewer complications and shorter hospitalization time. Laparoscopy will be an ideal choice for treatment of SMACS.

关 键 词：肠系膜上动脉压迫综合征 腹腔镜 十二指肠环形引流术 临床效果 

分 类 号：R656[医药卫生—外科学]