摘要
目的探讨粘连性肠梗阻实施腹腔镜粘连松解术治疗的效果及预后状况。方法选择信阳市中医院外科80例粘连性肠梗阻患者(2017年1月-2018年5月间)进行研究,对所有患者均施以腹腔镜粘连松解术治疗,了解患者围术期指标状况、中转开腹手术状况、并发症、术后复发状况。结果80例患者中78例患者顺利实施腹腔镜粘连松解术,其余2例患者因粘连严重松解困难而中转开腹手术,手术成功率为97.5%。78例顺利实施腹腔镜粘连松解术患者平均手术时间为(74.5±15.3)min;平均术中出血量为(74.5±15.3)m L;平均术后下床活动时间为(11.2±1.3)h;平均术后排气时间为(17.5±1.5)h。平均术后24h疼痛评分为(3.1±0.5)分,术后镇痛药物使用率为5.1%。平均住院时间为(5.3±0.6)d。78例顺利实施腹腔镜粘连松解术患者术后未出现严重并发症,并发症总发生率为1.3%。术后随访1年,78例患者中仅1例患者出现间歇性腹痛症状,复查后确诊为粘连性肠梗阻复发,术后1年肠梗阻复发率为1.3%。结论粘连性肠梗阻实施腹腔镜粘连松解术治疗创伤较小,手术状况较好,中转开腹风险较低,且术后并发症少,恢复较快,复发风险低,效果满意。
Objective To investigate the effect and prognosis of laparoscopic adhesion release for adhesive ileus.Methods 80 cases of adhesive ileus treated in the surgery department of Xinyang Hospital of TCM from January 2017 to May 2018 were selected for the study.All the patients were treated with laparoscopic adhesion lysis to understand the perioperative index status,transfer to open surgery status,complications and postoperative recurrence of the patients.Results 78 patients were successfully treated with laparoscopic adhesion release,and the other 2 patients were transferred to open surgery due to severe adhesion release,with a success rate of 97.5%.The average operation time of patients undergoing laparoscopic adhesion lysis was(74.5±15.3)min,the average intraoperative blood loss was(74.5±15.3)mL,the mean postoperative time of getting out of bed was(11.2±1.3)h,the mean postoperative exhaust time was(17.5±1.5)h.The average postoperative pain score was(3.1±0.5)points at 24h,and the rate of postoperative analgesic drug utilization was 5.1%,the average length of stay was(5.3±0.6)d.No serious complications occurred in the patients who underwent laparoscopic adhesion lysis successfully,and the total incidence of complications was 1.3%.After 1 year of follow-up,only 1 of the 78 patients had intermittent abdominal pain,and was diagnosis a recurrence of adhesive ileus after review,and the recurrence rate of ileus was 1.3%1 year after surgery.Conclusion Laparoscopic adhesion release for adhesive ileus is not only has less traumatic,better operative status and lower risk of translocation to laparotomy,but also has less postoperative complications,faster recovery,low risk of recurrence,and satisfactory results.
作者
穆凌杰
MU Lingjie(Department of Surgery,Xinyang Hospital of TCM,Xinyang Henan 464000,China)
出处
《临床研究》
2020年第5期41-42,共2页
Clinical Research
