腹腔镜与开腹粘连松解术治疗粘连性肠梗阻患者的疗效比较  

Comparison of Laparoscopic and Open Adhesive Loosening in the Treatment of Adhesive Intestinal Obstruction

作　　者：谷长宇 GU Changyu(Donggang City Central Hospital,Donggang 118300,China)

机构地区：[1]东港市中心医院,辽宁东港1183000

出　　处：《中国医药指南》2021年第31期46-48,共3页Guide of China Medicine

摘　　要：目的探索腹腔镜与开腹粘连松解术在粘连性肠梗阻患者中的治疗效果。方法在本院2018年3月至2019年5月收治的粘连性肠梗阻患者中选出138例为研究对象,根据患者的治疗意愿分为腹腔镜组和开腹组,每组69例。收集两组的手术指标及治疗效果。结果两组的手术时间、手术切口长度、术中出血量对比,差异均有统计学意义(P<0.001);腹腔镜组的术后镇痛药物使用率低于开腹组(P<0.05);腹腔镜组患者的术后镇痛消失时间、肠蠕动恢复时间、术后下床活动时间、术后住院时间均短于开腹组(P<0.001);腹腔镜组患者术后3 d的血清IL-6、CRP、TNF-α水平均明显低于对照组(P<0.05);腹腔镜组的并发症发生率低于开腹组的并发症发生率(P<0.05);随访1年后,腹腔镜组粘连性肠梗阻复发率低于开腹组(P<0.05)。结论腹腔镜下粘连松解术在粘连性肠梗阻患者中的效果确切,利于减轻手术创伤,促进患者术后尽早康复。Objective To explore the effect of laparoscopy and laparotomy in the treatment of adhesive intestinal obstruction.Methods A total of 138 patients with adhesive intestinal obstruction were selected from March 2018 to May 2019.The patients were divided into laparoscopy group and laparotomy group according to their treatment wishes,69 cases in each group.The surgical indexes and treatment effect of the two groups were collected.Results There were significant differences in operation time,incision length and intraoperative blood loss between the two groups(P<0.001).The postoperative analgesic drug utilization rate in laparoscopy group was lower than that in laparotomy group(P<0.05),and that in laparoscopy group was significantly lower than that in laparoscopy group(P<0.05).The disappearance time of analgesia,the recovery time of intestinal peristalsis,the time of getting out of bed after operation and hospitalization time after operation were shorter than those of laparotomy group(P<0.001).The serum levels of IL-6,CRP and TNF-αin the laparoscopic group were measured 3 days after operation were significantly lower than those in the control group(P<0.05).The complication rate of laparoscopy group was lower than that of laparotomy group(P<0.05).The recurrence of adhesive ileus in laparoscopic group was lower than laparotomy group(P<0.05).Conclusion Laparoscopic adhesive loosening is effective in patients with adhesive intestinal obstruction,reduces surgical trauma and promotes early recovery after operation.

关 键 词：粘连性肠梗阻 腹腔镜粘连松解术 开腹手术 手术创伤 术后恢复 

分 类 号：R574[医药卫生—消化系统]