腹腔镜探查肠粘连松解术治疗老年粘连性肠梗阻的安全性与预后情况分析
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摘要
目的观察腹腔镜探查肠粘连松解术治疗老年粘连性肠梗阻的安全性及预后情况。方法选取我院2016年3月至2018年2月收治的粘连性肠梗阻老年患者76例,随机分为对照组和观察组各38例。对照组采用常规开腹手术治疗,观察组采用腹腔镜探查肠粘连松解术治疗,观察对比两组患者的手术情况、并发症及复发情况。结果观察组的术中出血量、切口长度、手术时间、排气时间及止痛药使用率均明显优于对照组(P <0.05)。观察组的并发症发生率为5.26%,明显低于对照组的31.58%(P<0.05)。观察组的复发率为2.63%,明显低于对照组的15.79%(P <0.05)。结论腹腔镜探查肠粘连松解术治疗老年粘连性肠梗阻患者能有效改善患者的手术情况及预后,降低并发症发生率,值得临床推广。
Objective To observe the safety and prognosis of laparoscopic exploration of intestinal adhesiolysis in the treatment of senile adhesive intestinal obstruction. Methods 76 cases of elderly patients with adhesive intestinal obstruction admitted to our hospital from March 2016 to February 2018 were selected and randomly divided into control group and observation group, with 38 cases in each group.The control group was treated with conventional open surgery. The observation group was treated with laparoscopic exploration of intestinal adhesiolysis. The operation conditions, complications and prognosis were observed and compared between the two groups. Results The intraoperative blood loss, incision length, operation time, exhaust time and use rate of analgesics of the observation group were significantly better than those of the control group(P <0.05). The incidence of complications of the observation group was 5.26%, significantly lower than31.58% of the control group(P <0.05). The recurrence rate of the observation group was 2.63%, significantly lower than 15.79% of the control group(P <0.05). Conclusions Laparoscopic exploration of intestinal adhesiolysis in the treatment of elderly patients with adhesive intestinal obstruction can effectively improve the operation conditions and prognosis, and reduce the incidence of complications, which is worthy of clinical promotion.
Objective To observe the safety and prognosis of laparoscopic exploration of intestinal adhesiolysis in the treatment of senile adhesive intestinal obstruction. Methods 76 cases of elderly patients with adhesive intestinal obstruction admitted to our hospital from March 2016 to February 2018 were selected and randomly divided into control group and observation group, with 38 cases in each group.The control group was treated with conventional open surgery. The observation group was treated with laparoscopic exploration of intestinal adhesiolysis. The operation conditions, complications and prognosis were observed and compared between the two groups. Results The intraoperative blood loss, incision length, operation time, exhaust time and use rate of analgesics of the observation group were significantly better than those of the control group(P <0.05). The incidence of complications of the observation group was 5.26%, significantly lower than31.58% of the control group(P <0.05). The recurrence rate of the observation group was 2.63%, significantly lower than 15.79% of the control group(P <0.05). Conclusions Laparoscopic exploration of intestinal adhesiolysis in the treatment of elderly patients with adhesive intestinal obstruction can effectively improve the operation conditions and prognosis, and reduce the incidence of complications, which is worthy of clinical promotion.
引文
[1]马东波.腹腔镜探查肠粘连松解术治疗老年粘连性肠梗阻患者的临床疗效[J].医疗装备, 2017, 30(18):139-140.
[2] Saklani AP, Naguib N, Shah PR, et al. Adhesive intestinal obstruction in laparoscopic vs open colorectal resection[J]. Colorectal Dis, 2013,15(1):80-84.
[3]李浩.腹腔镜探查肠粘连松解术与传统开腹手术治疗老年粘连性肠梗阻临床研究[J].临床研究, 2015, 23(5):107-108.
[4]侯开庆,彭勃.腹腔镜手术治疗粘连性肠梗阻16例疗效观察[J].海南医学, 2016, 27(4):637-638.
[5] Kelly KN, Iannuzzi JC, Rickles AS, et al. Laparotomy for small-bowel obstruction:first choice or last resort for adhesiolysis? A laparoscopic approach for small-bowel obstruction reduces 30-day complications[J]. Surg Endosc, 2014, 28(1):65-73.
[6] Lombardo S, Baum K, Filho JD, et al. Should adhesive small bowel obstruction be managed laparoscopically? A National Surgical Quality Improvement Program propensity score analysis[J]. J Trauma Acute Care Surg, 2014, 76(3):696-703.
[7]李鸷.腹腔镜探查肠粘连松解术治疗老年粘连性肠梗阻的有效性与安全性[J].中国老年学杂志, 2016, 36(14):3492-3494.
[2] Saklani AP, Naguib N, Shah PR, et al. Adhesive intestinal obstruction in laparoscopic vs open colorectal resection[J]. Colorectal Dis, 2013,15(1):80-84.
[3]李浩.腹腔镜探查肠粘连松解术与传统开腹手术治疗老年粘连性肠梗阻临床研究[J].临床研究, 2015, 23(5):107-108.
[4]侯开庆,彭勃.腹腔镜手术治疗粘连性肠梗阻16例疗效观察[J].海南医学, 2016, 27(4):637-638.
[5] Kelly KN, Iannuzzi JC, Rickles AS, et al. Laparotomy for small-bowel obstruction:first choice or last resort for adhesiolysis? A laparoscopic approach for small-bowel obstruction reduces 30-day complications[J]. Surg Endosc, 2014, 28(1):65-73.
[6] Lombardo S, Baum K, Filho JD, et al. Should adhesive small bowel obstruction be managed laparoscopically? A National Surgical Quality Improvement Program propensity score analysis[J]. J Trauma Acute Care Surg, 2014, 76(3):696-703.
[7]李鸷.腹腔镜探查肠粘连松解术治疗老年粘连性肠梗阻的有效性与安全性[J].中国老年学杂志, 2016, 36(14):3492-3494.