不同手术时机在治疗急性肠梗阻中的效果观察

目的探讨不同手术时机在治疗急性肠梗阻中的疗效差别。方法回顾性分析172例急性肠梗阻患者,根据治疗过程分为4组。采取保守治疗治愈者37例(A组),发病24h内行手术治疗者57例(B组),发病24～72h内行手术治疗者49例(C组),发病超过72h行手术治疗者29例(D组)。比较4组患者肠坏死率、病死率及恢复时间。结果 A组患者在肠坏死率及病死率方面低于C、D组(P<0.05),A、B组患者在肠坏死率及病死率上,差异无统计学意义(P>0.05);A组患者恢复时间均短于其他3组(P<0.05),手术治疗患者中,越早进行手术,恢复时间越短(P<0.05)。结论对需要手术治疗患者尽早进行手术能取得较好预后,手术时机可依靠腹痛、血压、血象等指征进行判断。

Objective Research the curative effect of different operation time in the treatment of acute intestinal obstuction. Methods 172 cases of acute intestinal obstruction were reviewed retrospectively. They were divided into 4 groups based on the treatment. 37 cases who were cured by conservative theatment were in A group. 57 cases were in B groups,who took surgical treatment in 24h, 49 cases were in C groups of taking surgical treatment in 24- 72h. 29 cases were in D group, taking surgical treatment more than 72h. Compare the difference of the rate of intestinal necrosis and mortality and the recovery time. Results A group was lower than the B and C group in the rate of intestinal necrosis and mortality （P〈0.05）. A had no significant difference in the two rate with B group.The recovery time in A group was shorter than the other groups （P〈0.05） and earlier take the surgical treatment, it was shorter in the recovery time（P〈0.05）. Conclusion It will take a better prognosis if earlier taking surgical treatment for the patient who needs it. Rely on the stomachache, blood pressure, herogram to judge the time of operation.