腹腔镜下粘连松解术治疗粘连性肠梗阻的临床效果附68例病例分析  

Clinical effect of laparoscopic adhesiolysisfor the treatment of adhesive intestinal obstruction:analysis of 68 cases

作　　者：王志 李海 文正荣 Wang Zhi;Li Hai;Wen Zhengrong(The second hepatobiliary surgical department,people's hospital of Chuxiong prefecture,Chuxiong,Yunnan,675000,China)

机构地区：[1]楚雄州人民医院肝胆外二科,云南楚雄675000

出　　处：《齐齐哈尔医学院学报》2023年第11期1023-1026,共4页Journal of Qiqihar Medical University

摘　　要：目的 比较常规开腹与腹腔镜下对粘连性肠梗阻行粘连性松解术治疗的临床效果,为粘连性肠梗阻的治疗术式选择提供依据。方法 回顾性分析2018年2月—2021年3月本院收治的68例粘连性肠梗阻患者的病历资料,其中常规开腹(laparotomy,LT)行连粘性松解手术治疗的32例患者设为LT组,通过腹腔镜(Laparoscope,LS)行粘连松解术治疗的36例患者设为LS组,对两组不同术式治疗患者的实际手术时间、术中出血量、术后肠胃功能恢复、住院时间以及并发症(切口感染、术后腹膜炎)发生率进行统计学分析。结果 治疗总有效率LS组>LT组(97.22%>87.50%),差异具有统计学意义(P<0.05);与LT组相比,LS组患者手术时间短,术中出血量少,肠胃功能恢复快,平均住院时间短,差异具有统计学意义(P<0.05);患者并发症发生率LT组>LS组(12.50%>5.56%),差异具有统计学意义(P<0.05)。结论 粘连性肠梗阻通过腹腔镜粘连松解术治疗,较常规开腹手术治疗优势明显,表现在手术时间短、出血少、肠胃功能恢复快,住院时间短且并发症发生率低,具有临床推广应用价值。Objective To compare the clinical effects of conventional laparotomy and laparoscopicadhesiolysisin treatingadhesive ileus,in order to provide a basis for the selection of treatment methods for adhesive ileus.Methods The disease data of 68 patients suffered from adhesive ileus those were admitted to our hospital between February 2018 and March 2021 were analyzed retrospectively.The patients who received conventional laparotomy(LT) for adhesiolysis were enrolled in LT group(n=32),and the patients who underwent laparoscopic(LS) adhesiolysis were employedin LS group(n=36).The actual operation time,intraoperative blood loss,postoperative gastrointestinal function recovery,the hospital stay and the incidence of complications(incision infection and postoperative peritonitis) of the two groups were statistically analyzed.Results The total effective rate of LS group was higher than that of LT group(97.22%>87.50%),the difference was statistically significant(P<0.05).Compared with LT group,LS group had shorter operation time,less intraoperative bleeding,faster recovery of gastrointestinal function,and shorter average hospital stay,with significant differences(P<0.05).The incidence of complication in LT group was higher than that in LS group(12.50%>5.56%),and the difference was statistically significant(P<0.05).Conclusions Patients suffered from adherent intestinal obstruction those were treated by laparoscopic adhesiolysis achieved obvious advantages over conventional open surgery,and the advantages mainly including such as short operation time,less bleeding,fast recovery of gastrointestinal function,short hospital stay and low complication rate.It has clinical application value.

关 键 词：腹腔镜粘连松解术 粘连性肠梗阻 临床效果 

分 类 号：R656.7[医药卫生—外科学]