摘要
目的观察腹腔镜用于急性粘连性肠梗阻病人治疗中的效果。方法从2014年3月至2016年3月住院的急性粘连性肠梗阻146例病人中选取80例为研究对象,占同时期肠梗阻病人的54.79%,80例病人均行手术治疗。应用随机数字表将所有病人分成两组,腹腔镜组与开腹组,每组各40例。根据术中失血量、手术时间、术后排气时间、住院时间、术后并发症发生率及术后病人的生存质量评分比较两种手术方法的疗效。结果腹腔镜组病人术中失血量(98.24±8.58)ml明显少于开腹的(201.36±21.57)ml;腹腔镜组手术时间为(81.33±6.89)min、术后排气时间为(20.43±4.65)h、住院时间为(5.8±0.9)d均短于开腹组的(112.45±27.18)min、(42.14±8.64)h和(9.2±0.6)d,差异均有统计学意义(P<0.05);腹腔镜组并发症发生率(10.00%)与梗阻复发率(25.00%)明显低于开腹组的22.50%和37.50%,差异有统计学意义(P<0.05)。治疗前两组病人的降钙素原(PCT)、C反应蛋白(CRP)等指标差异无统计学意义(P>0.05),治疗腹腔镜组各个方面指标好于开腹组,差异均具有统计学意义(P<0.05),术后腹腔镜组病人的生存质量评分明显高于开腹组,差异具有统计学意义(P<0.05)。结论腹腔镜手术治疗急性粘连性肠梗阻的效果明显好于传统开腹手术,具有创伤性小,出血量少,手术时间短,术后恢复快,术后并发症少,可以有效改善病人的术后生存质量,值得在临床上推广使用。
Objective To observe the effectiveness of laparoscopy in the treatment of patients with acute adhesive intestinal obstruction. Methods From March 2014 to March 2016, 80 patients with acute adhesive intestinal obstruction in our hospital were selected as the research subjects that accounted for 54. 79% of patients with intestinal obstruction in the same period. All the patients were subjected to surgical treatment. All the patients were randomly divided into two groups： 40 patients in the laparoscopic group and 40 patients in the laparotomy group. The effectiveness in the two groups was compared according to the intraoperative blood loss, operation time, postoperative exhaust time, hospital stay, postoperative complication rate and postoperative quality of life scores of patients. Results The blood loss in the laparoscopic group [（98. 24±8. 58） mL] was significantly less than in the laparotomy group [ （201.36± 21.57） mL]. The operative time in laparoscopic group was （81.33 ± 6. 89） rain,postoperative exhaust time was （20. 43 ± 4. 65） h,and hospital stay was （5. 8 ± 0. 9） days,which were significantly shorter than in the laparotomy group [（112. 45± 27. 18） rain, （42. 14± 8. 64） h and （9. 2 ＋ 0. 6） days respectively, P〈0. 05 for all）. The incidence of complications in the laparoscopic group （10. 00%） and the recurrence rate of obstruction （25. 00%） were significantly lower than in the laparotomy group （22. 50% and 37. 50% ,P〈0. 05 for both）. Before treatment, there was no significant difference in procalcitonin （PCT） and C reactive protein （CRP） between two groups （P〈0. 05）,and after treatment, significant difference existed （P〈0. 05）. The postoperative survival quality scores of patients in the laparoscopic group were significantly higher than those in the laparotomy group （P〈 0. 05）. Conclusions Laparoscopic surgery in the treatment of acute adhesive intestinal obstruction is better than the traditional laparotomy with less inv
出处
《腹部外科》
2016年第6期455-458,共4页
Journal of Abdominal Surgery
关键词
腹腔镜手术
急性粘连性肠梗阻
开腹手术
疗效
Laparoscopic surgery
Acute intestinal obstruction
Laparotomy
Efficacy
