小儿剖腹手术后粘连性肠梗阻99例分析

Ten-year Retrospective Study of Adhesive Ileus After Laparotomy in Children

目的探讨小儿剖腹术后粘连性肠梗阻的发生原因与防范措施。方法回顾性分析我院小儿外科近10年来收治的99例剖腹术后粘连性肠梗阻患儿的病例资料。结果剖腹术后粘连性肠梗阻99例(占同期收治小儿肠梗阻病人总数的32.25%),其中,62例为本院小儿外科剖腹术后发生的粘连性肠梗阻(占同期剖腹手术总数的5.72%)。引起粘连的原发病前3位依次为先天性巨结肠、肠套叠、阑尾炎。65例采取手术治疗,34例采取保守治疗,两组出院后肠粘连复发情况比较,差异无统计学意义(P>0.05)。结论小儿剖腹术后腹膜粘连在临床中并不少见,预防研究应进一步深入,严格遵守手术操作规范,并积极开展腹腔镜等微创手术。

Objective To learn more about pediatric adhesive ileus after laparotomy by analysis data of ileus caused by postoperative adhesions.Methods Cases of pediatric adhesive ileus after laparotomy were reviewed in this ten-year retrospective study.Results There were 99 pediatric ileus cases caused by postoperative adhesions,which accounted for 32.25% of total pediatric ileus cases.62 cases of them were caused by operations which were performed in our department(5.72% of total laparotomy cases in the corresponding period).Three top of primary diseases which led to adhesion formation were hirschsprung's disease,intussusception,appendicitis.As the conservative treatment group compared with the operation treatment group,there was no significantly difference in the number of recurrence cases of adhesion in the two groups(P>0.05).Conclusions It is not the rare clinical situation of children with pediatric adhesive ileus after laparotomy.In order to decrease adhesions,it is necessary to develop prophylaxis measures,to follow the operative procedure standard strictly,should positively and develop mini-invasive operaction,such as laparoscopic surgery.