腹腔镜治疗粘连性肠梗阻疗效观察

Laparoscopic enterolysis on patients with adhesive intestinal obstruction

目的探讨腹腔镜治疗粘连性肠梗阻的疗效及优点。方法对9例粘连性肠梗阻患者在气管插管全身麻醉下采用电视腹腔镜设备行腹腔镜肠粘连松解术。结果7例患者完全在腹腔镜下松解粘连,1例腹腔镜下松解粘连后切小口行坏死肠管切除并吻合术,1例中转开腹,手术时间35～145 min,平均(74.5±1.3)min,术中出血量15～250 mL,平均(35.0±1.1)mL,住院时间5～9 d,平均(6.0±0.9)d,术后随访6个月至1 a,除1例患者因肠痉挛引起阵发腹痛外,余患者无症状,所有患者均未再发,亦无其他并发症。结论腹腔镜肠粘连松解术具有创伤小、手术时间短、腹腔暴露机会少、脏层腹膜干扰轻等特点,可以减少术后再发粘连。

Objective To investigate the curative effect and advantages of laparoseopie operation on patients with adhesive intestinal obstruction. Methods Nine patients with adhesive intestinal obstruction were performed with laparoseopie enterolysis under general anaesthesia. Results The adhesions in seven eases were disengaged completely by laparoseopie operation,one ease was made an incision to remove the necrotic small intestine after laparoseopie operation, one ease was treated with open surgery. The operation time was 35 to 145 min, （74.5 ±1. 3 ）rain on average. The intra-operative blood loss was 15 to 250 mL, （35.0 ± 1. 1 ） mL on average. The hospital stay was 5 to 9 days, （ 6.0±0.9 ） days on average. All patients were followed-up for 6 - 12 months after operation, no recurrence and other complications were found. Conclusion Laparoseopie enterolysis has advantages of minor trauma,little chance to abdominal cavity exposure, short operation time, minor interference to visceral peritoneum and so on. Laparoscopic enterolysis can decrease the recurrence.