慢性静止期与急性炎症发作期腹腔镜肠粘连松解术的临床疗效对比研究  

A comparative study on the clinical effect of laparoscopic adhesiolysis at the stage of chronic quiescence and acute inflammation

作　　者：刘国生 向珑 黄丽霞 LIU Guo-sheng;XIANG Long;HUANG Li-xia(Dongguan Qingxi Hospital,Dongguan 523660,China)

机构地区：[1]广东省东莞市清溪医院,523660

出　　处：《中国实用医药》2020年第12期25-27,共3页China Practical Medicine

基　　金：慢性静止期与急性炎症发作期腹腔镜肠粘连松解术的临床疗效对比研究,东莞市社会科技发展(重点/一般)项目(项目编号:201850715015865)。

摘　　要：目的对比粘连性肠梗阻患者于慢性静止期和急性炎症发作期采用腹腔镜肠粘连松解术治疗的效果。方法48例有腹部手术史并反复多次发作粘连性肠梗阻患者作为研究对象,根据手术时机分为实验组(22例)和对照组(26例)。两组患者均采取腹腔镜肠粘连松解术进行治疗,实验组患者于慢性静止期进行手术治疗,对照组于急性炎症发作期进行手术治疗。对比两组患者手术时间、术中出血量、胃肠功能恢复时间、腹痛消失时间及中转开腹、小肠切除、复发情况。结果两组患者的手术时间比较差异无统计学意义(P>0.05);实验组患者的术中出血量(50.3±8.4)ml少于对照组的(68.2±9.8)ml,胃肠功能恢复时间(2.8±0.2)d、腹痛消失时间(3.1±0.5)d均短于对照组的(4.2±0.6)、(5.2±0.9)d,差异均具有统计学意义(P<0.05)。实验组患者中转开腹率4.5%、小肠切除率4.5%以及复发率0均明显低于对照组的26.9%、26.9%、19.2%,差异均具有统计学意义(P<0.05)。结论有腹部手术史并反复多次发作粘连性肠梗阻患者于慢性静止期采取腹腔镜肠粘连松解术治疗的效果更好,安全性更高,复发率更低,值得临床大力推广应用。Objective To compare the effect of laparoscopic adhesiolysis in patients with adhesive intestinal obstruction at the stage of chronic quiescence and acute inflammation.Methods A total of 48 patients with a history of abdominal surgery and repeated episodes of adhesive intestinal obstruction as study subjects were divided by surgery timing into experimental group(22 cases)and control group(26 cases).Both groups were treated by laparoscopic adhesiolysis.Patients in the experimental group were operated in the stage of chronic quiescence,while the patients in the control group were operated in the stage of acute inflammation.The operation time,amount of intraoperative hemorrhage,recovery time of gastrointestinal function,disappearance time of abdominal pain,conversion to laparotomy,enterotomy and recurrence situation were compared between the two groups.Results There was no statistically significant difference in operation time between the two groups(P>0.05).The amount of intraoperative hemorrhage(50.3±8.4)ml of the experimental group was less than that of the control group(68.2±9.8)ml,and recovery time of gastrointestinal function(2.8±0.2)d,disappearance time of abdominal pain(3.1±0.5)d were all shorter than those of the control group(4.2±0.6)and(5.2±0.9)d.The difference was statistically significant(P<0.05).The rate of conversion to laparotomy 4.5%,small bowel resection rate 4.5%and recurrence rate 0 of the experimental group were obviously lower than those of the control group 26.9%,26.9%and 19.2%,and the difference was statistically significant(P<0.05).Conclusion For patients with a history of abdominal surgery and repeated episodes of adhesive intestinal obstruction,laparoscopic adhesiolysis at the stage of chronic quiescence is more effective,safe with less recurrence rate,which is worthy of clinical promotion and application.

关 键 词：慢性静止期 急性炎症发作期 腹腔镜肠粘连松解术 临床研究 

分 类 号：R656.7[医药卫生—外科学]