腹腔镜与开腹肠粘连松解术的疗效分析

Analysis of the efficacy of open surgery and laparoscopic surgery in the treatment of intestinal obstruction

目的：比较开腹手术与腹腔镜手术治疗粘连性肠梗阻的近期疗效,探讨腹腔镜手术诊治粘连性肠梗阻的应用价值。方法：回顾分析2008年1月至2014年12月手术治疗的粘连性肠梗阻患者的临床资料,其中48例行腹腔镜手术（腹腔镜组）,36例行开腹手术（开腹组）。对比分析两组患者手术时间、术后肠道功能恢复时间、术后住院时间等指标。结果：两组患者均痊愈出院,术后随访6~36个月。腹腔镜组中位手术时间50 min,中位术后肠道排气时间2 d,中位术后住院时间6 d;发生切口感染2例,随访无复发。各项指标均优于开腹组,两组差异有统计学意义（P〈0.05）。结论：腹腔镜手术治疗粘连性肠梗阻具有患者创伤小、术后康复快、并发症少、复发率低等优点,是治疗粘连性肠梗阻的有效措施。

Objective： To compare the short-term therapeutic effect of open surgery and laparoscopic surgery in the treatment of adhesive intestinal obstruction,and to explore the application value of laparoscopy in the diagnosis and treatment of adhesive intestinal obstruction. Methods： The clinical data of 84 patients with adhesive intestinal obstruction who underwent surgical treatment from Jan.2008 to Dec. 2014 were retrospectively analyzed. 48 patients were treated with laparoscopic operation and 36 patients were treated by open operation. The operation time,postoperative intestinal recovery time,postoperative hospital stay and other aspects of the treatment effect of two different operations were comparatively analyzed. Results： The patients in two groups were all cured and discharged,and the follow-up was 6-36 months. In the laparoscopic group,median operative time was 50 min. Median postoperative intestinal exhaust time was 2 d. Median postoperative hospital stay was 6 d,incision infection occurred in 2 cases. No recurrence was found during follow-up.The indicators of laparoscopic group were better than those of the open group,the difference between the two groups was statistically significant（ P 0. 05）. Conclusions： Laparoscopic operation in treatment of adhesive intestinal obstruction has the advantages of less trauma,quicker recovery,less complications and lower recurrence rate. It is an effective treatment for adhesive intestinal obstruction.