标题：腹腔镜与开腹黏连松解术治疗黏连性肠梗阻疗效比较

      作者：朱宏升，桑宝华    城固县医院普通外科，陕西 城固 723200

      卷次： 2019年30卷15期

      【摘要】 目的 比较腹腔镜与开腹黏连松解术治疗黏连性肠梗阻的临床疗效。方法 回顾性分析城固县医院普通外科2018年1月至2019年1月收治的110例黏连性肠梗阻患者的术后恢复情况。根据手术方法的不同进行分组，其中55例行开腹黏连松解术者为对照组，55例行腹腔镜下黏连松解术者为观察组。比较两组患者的治疗效果、手术情况(手术时间、出血量、切口长度、肠蠕动正常时间、下床时间)、疼痛评分及并发症情况。结果 观察组患者的治疗总有效率为94.55%，明显高于对照组的81.81%，差异有统计学意义(P<0.05)；观察组患者的手术时间、肠蠕动正常时间、下床时间分别为(72.56±20.32) min、(21.32±4.13) h、(21.35±5.57) h，均明显短于对照组的(123.42±19.32) min、(98.54±10.35) h、(50.34±10.55) h，出血量、切口长度分别为(25.04±8.67) mL、(3.76±0.66) cm，明显小于对照组的(151.54±18.79) mL、(20.71±5.42) cm，差异均有统计学意义(P<0.05)；观察组患者的疼痛评分为(2.04±1.13)分，明显低于对照组的(4.21±0.12)分，差异有显著统计学意义(P<0.01)；观察组并发症发生率为 3.64%，明显低于对照组的16.36%，差异有统计学意义(P<0.05)。结论 与开腹黏连松解术比较，腹腔镜下黏连松解术治疗黏连性肠梗阻的优势更明显，其不仅能够提高疗效，改善患者手术各项指标，减小疼痛，还能降低并发症的发生率，加快患者恢复，值得推广应用。
      【关键词】 开腹黏连松解术；黏连性肠梗阻；腹腔镜；疗效；预后
      【中图分类号】 R574.2 【文献标识码】 A 【文章编号】 1003—6350（2019）15—1944—03

Effect of laparoscopic and open adhesiolysis in the treatment of adhesive intestinal obstruction.
ZHU Hong-sheng,SANG Bao-hua. Department of General Surgery, Chenggu County Hospital, Chenggu 723200, Shaanxi, CHINA
【Abstract】 Objective To compare the clinical efficacy of laparoscopic and open adhesiolysis in the treatmentof adhesive intestinal obstruction. Methods The postoperative recovery data of 110 patients with adhesive intestinal ob-struction admitted to the Department of General Surgery, Chenggu County Hospital from January 2018 to January 2019were retrospectively analyzed. According to the different surgical methods, 55 patients treated with open adhesiolysiswere divided into the control group, and 55 patients treated with laparoscopic adhesiolysis were divided into the observa-tion group. The curative effect, operation condition (operation time, bleeding volume, incision length, normal time of in-testinal peristalsis, time of getting out of bed), pain score, and complications were compared between the two groups.Results The total effective rate of the observation group was 94.55%, which was significantly higher than 81.81% ofthe control group (P<0.05). The operation time, normal time of intestinal peristalsis, and time of getting out of bed in theobservation group were (72.56±20.32) min, (21.32±4.13) h, and (21.35±5.57) h, respectively, which were significantlyshorter than (123.42±19.32) min, (98.54±10.35) h, and (50.34±10.55) h in the control group. The amount of bleedingand the length of incision were (25.04±8.67) mL and (3.76±0.66) cm, respectively, which were significantly smallerthan (151.54±18.79) mL and (20.71±5.42) cm in the control group (P<0.05). The pain score of the observation groupwas 2.04±1.13, which was significantly lower than 4.21±0.12 of the control group (P<0.01). The incidence of compli-cations in the observation group was 3.64%, which was significantly lower than 16.36% in the control group (P<0.05).Conclusion Compared with open adhesiolysis, laparoscopic adhesiolysis has more advantages in the treatment of ad-hesive intestinal obstruction. It can not only improve the curative effect, improve surgical indicators, reduce pain, but al-so reduce the incidence of complications and accelerate the recovery of patients. It is worth popularizing and applying.
      【Key words】 Open adhesiolysis; Adhesive intestinal obstruction; Laparoscopy; Curative effect; Prognosis