摘要
目的探讨急需手术治疗的急性粘连性肠梗阻患者的治疗。方法分析2002年1月至2011年6月219例急性粘连性肠梗阻患者的临床资料。按治疗方式不同分组:传统开腹手术治疗组(A组)、传统开腹手术联合中药治疗组(B组)、腔镜手术治疗组(C组)、腔镜手术联合中药治疗组(D组)。结果符合入组条件的A组86例、B组67例、C组31例、D组35例。4组肠道功能恢复时间、进食时间、住院天数比较差异有统计学意义(F值分别为245.151、290.237、106.878,P=0.000),A组最差,D组较优。4组术日(术前)白细胞计数比较差异无统计学意义(F=0.055,P=0.983),术后第1天、第2天、第3天的白细胞计数比较差异有统计学意义(F值分别为37.442、38.689、28.182,P=0.000),D组恢复最快,A组最差。术后随访A组常伴腹痛21例(24.42%),需再次手术治疗12例(13.95%);B组腹痛9例(13.43%),需再次手术5例(7.46%);C组腹痛3例(9.68%),1例需再次手术治疗(3.23%);D组腹痛2例(5.71%),无再手术病例。4组腹痛及需再手术的发生率比较差异有统计学意义(χ2分别8.549、7.958,P分别0.039、0.047),D组优于其它各组。结论有适应证的急性粘连性肠梗阻患者,首选腔镜手术联合中药治疗,腔镜手术失败或无适应证者选择开腹手术辅助中药治疗。
Objective To study the surgical treatment of acute adhesion ileus that need urgent operation.Methods Clinical data of 219 cases of acute adhesion ileus from January 2002 to June 2011 were analyzed.According to the different treatment,there were four groups：traditional operation treatment group（Group A）,traditional Chinese medicine combined surgery treatment group（Group B）,laparoscopic operation group（Group C）,and laparoscopic operation combianed traditional Chinese medicine treatment group（group D）.Results On the grouping conditions,86 patients were divided into group A,67 patients into group B,31 patients into group C,and 35 patients into group D.There were statistical significance in recovery time of bowel function,food-taking time and days in hospital among the four groups（F value,245.151,290.237 and 106.878,P =0.000）,with the worst result in group A and excellent in group D.The preoperative white blood count had no difference（F =0.055,F =0.983）,but statistical differences appeared in 1st,2nd,3rd day after operation（F value were 37.442,38.689 and 28.182,F =0.000）.The group D restored fast,and group A wass the worst.During the follow-up time,the abdominal pain occured in 21cases（24.42%）of group A,and 12cases（13.95%）required surgical treatment again.The abdominal pain recurred in 9cases（13.43%）of group B,and 5patients（7.46%）required surgery again.The abdominal pain recurred in 3patients（9.68%）of group C,and 1case required surgery（3.23%）.Two（5.71%）cases of group D developed abdominal pain,but without operation again.The abdominal pain and incidence of reoperation in four groups had statistical significance（χ2 value,8.549,7.958;p value,0.039,0.047,respectively）,and the group D was the best.Conclusion The laparoscopic operation combianed traditional Chinese medicine should be preferred in acute adhesion ileus patients with surgical indications.If failure in laparoscopic operation,traditional Chinese medicine combined surgery treatment might be choosed.
出处
《结直肠肛门外科》
2014年第5期318-321,共4页
Journal of Colorectal & Anal Surgery
关键词
肠梗阻
腹腔镜手术
开腹手术
中药
Obstruction/surgery
Operation
Traditional Chinese medicine
Curative effect
