| 查小应 费哲为 陈大伟 张捷 高铭 黄磊 张超峰.腹腔镜手术治疗粘连性肠梗阻的疗效及安全性研究[J].,2015,15(35):6892-6895 |
| 腹腔镜手术治疗粘连性肠梗阻的疗效及安全性研究 |
| Efficacy and Safety of Laparoscopic Surgery in the Treatment of AdhesiveIntestinal Obstruction |
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| DOI： |
| 中文关键词: 粘连性肠梗阻 腹腔镜 粘连松解术 肠梗阻 |
| 英文关键词: Adhesive intestinal obstruction Laparoscopy Adhesiolysis Intestinal Obstruction |
| 基金项目:上海交通大学医学院附属新华医院崇明分院科研基金项目（M201303） |
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| 中文摘要: |
| 目的：探讨腹腔镜粘连松解术治疗粘连性肠梗阻（AIO）的疗效，减少再梗阻率。方法：将120 例AIO 患者随机分为两组，每
组60 例，开腹组实施开腹手术，腹腔镜组实施腹腔镜粘连松解术，观察两组术后恢复及并发症发生情况，对再梗阻危险因素进行
Logistic 回归分析。结果：腹腔镜组术中失血量（73.48± 9.32）mL，少于开腹组的（207.45± 33.21）mL（P<0.05）；腹腔镜组手术、术后
镇痛、下床活动、肠恢复蠕动、肛门恢复排气、拔除尿管及住院时间分别为（69.15± 10.13）min、（14.67± 7.23）h、（27.14± 7.04）h、
（3.11± 0.96）d、（3.24± 1.02）d、（3.37± 1.23）d、（7.95± 3.05）d，均短于开腹组的（83.84± 9.24）min、（27.38± 8.02）h、（36.23± 5.87）
h、（4.05± 1.35）d、（4.35± 1.74）d、（5.02± 2.13）d、（10.35± 3.71）d（P<0.05)；腹腔镜组并发症发生率、再梗阻率分别为10.00%、
10.00%，均低于开腹组的33.33%、40.00%（P<0.05)；多因素Logistic 回归分析显示开腹手术、手术时间≥ 60 min 是再梗阻发生的独
立危险因素。结论：腹腔镜手术治疗AIO 疗效优于开腹手术，而且并发症与再梗阻率低。 |
| 英文摘要: |
| Objective:To investigate clinical efficacy of laparoscopic AIO to reduce the rate of re-obstruction.Methods:The 120
patients with AIO were randomly divided into two groups, 60 cases in each group. Patients in the open surgery group had implementation
of open surgery, while those in the laparoscopy group had laparoscopic adhesion lysis. We observed the postoperative recovery and complications,
and applied the Logistic regression to analyze the risk factors of obstruction-reoccurrence.Results:In the laparoscopic group,
the intraoperative blood loss had (73.48± 9.32) mL, less than in the open surgery group (207.45± 33.21) mL (P<0.05); The time for
surgery, postoperative pain, ambulation, bowel motility recovery anal exhaust recovery, removal of catheter and hospital stay were respectively
(69.15± 10.13) min, (14.67± 7.23) h, (27.14± 7.04) h, (3.11± 0.96) d, (3.24± 1.02) d, (3.37± 1.23) d, (7.95± 3.05) d, all
shorter than those in the open surgery group which were respectively (83.84± 9.24) min, (27.38± 8.02) h, (36.23± 5.87) h, (4.05± 1.35)
d, (4.35± 1.74) d, (5.02± 2.13) d, (10.35± 3.71) d (P<0.05). The incidence of complications and obstruction reoccurrence rate both were
10.00%in laparoscopic group, lower than in the open surgery group which had 33.33%and 40.00% respectively (P<0.05). Multivariate
logistic regression analysis showed that laparotomy and operative time≥ 60min were the independent risk factors for re-obstruction.Conclusion:Laparoscopic surgery for AIO was effective than open surgery, and had fewer complications and lower rate of re-obstruction. |
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