顽固性肠粘连、粘连性肠梗阻的诊治及预防

The diagnosis and treatme nt and prevention of the intractable intestinal adhesion and adhesive ileus

目的 探讨腹腔镜松解术治疗反复发作顽固性的肠粘连、粘连性肠梗阻的可行性和临床效果.方法 在腹腔镜下使用分离钳、电凝、分离剪及超声刀对23例肠粘连、粘连性肠梗阻患者行粘连松解术.结果 患者均确诊为肠粘连、粘连性肠梗阻,术后随防2～24个月,恢复良好,其中4例偶有腹胀、腹痛,自行缓解,其余均无腹痛、腹胀等症状复发,均未再有肠粘连、粘连性肠梗阻的表现.结论 利用腹腔镜对肠粘连、粘连性肠梗阻有选择地进行粘连松解手术安全、可行,且其具有创伤小、出血少、恢复快、瘢痕少、费用少等微创外科的优点,基本没有再粘连的发生.

Objective To ivestigate the feasibility and clinical effect of laparoscopic lysis in treatment of recurrent and intractable intestinal adhesion and adhesive ileus. Methods 23 patients with intestinal adhesion and adhesive ileus were adopted laparoscopic lysis adhesion by using separating pliers, electrocoagulation,separated shear and ultrasonic knife. Results All the patients were diagnosed with intestinal adhesion and adhesive ileus,and they recovered well af- ter they were conducted postoperative follow-up for 2-24 months.Occasional abdominal distension and abdominal pain occurred in 4 cases,and it could alleviate by oneself.The rest had no recurrence of symptoms such as abdominal pain and abdominal distention.All had no recurrence of intestinal adhesion and adhesive ileus. Conclusion The selective la- paroscopie lysis adhesion is safe and feasible to treat intestinal adhesion and adhesive ileus.Laparoseopic [ysis adhe- sion has advantages of minimally invasive surgery in treatment of adhesive intestinal obstruction,and it has the advan- tages of minimally invasive surgery with small trauma,less bleeding,faster recovery,little sear, less cost etc. Adhesion does not recur basically.