腹腔镜用于粘连性肠梗阻诊治的效果分析

The effect of laparoscopic in the diagnosis and treatment of adhesive intestinal obstruction

目的探讨腹腔镜用于粘连性肠梗阻诊治中的效果。方法选取我院2007年7月～2015年12月收治粘连性肠梗阻患者59例；按收治时间前后，前29例行开腹手术（对照组），后30例行腹腔镜手术（观察组）；比较两组术中、术后各临床指标，以及术后并发症发生情况。结果术后两组PA水平均较术前提高，CRP水平、PCT水平均较术前显著降低，差异有统计学意义（P〈0．05）；对照组PA升高较观察组更为显著，CRP、PCT水平观察组降低更为显著（P〈0．05）；两组手术时间比较，差异无统计学意义（P〉0．05）；术中出血量（48.3±6．8）mL、术后下地活动时间（12．5±1．8）h、恢复肠胃功能时间（3．0±0．5）h、出院时间（5．1±0．7）d等，观察组较对照组[（70．4±9．7）mL、（68．2±12．7）h、（4．6±1．2）h、（9．7±1．4）d]更具优势，差异有统计学意义（P〈0．05）；观察组手术并发症出现3种3例，发生率为10．0％，对照组并发症5种14例，发生率为48．3％，差异有统计学意义（P〈0．05）。结论腹腔镜用于粘连性肠梗阻诊治中，手术创伤小降低了出血量，且炎症反应轻微、并发症少、有助于患者术后恢复，值得临床推广。

Objective To explore the effect of laparoscopic in the diagnosis and treatment of adhesive intestinal obstruction. Methods 59 cases of patients with adhesive intestinal obstruction cured in our hospital from July 2007 to December 2015 were selected as the research objects. According to the time before and after the treatment,the first 29 cases underwent laparotomy surgery （control group）, and the after 30 cases underwent laparoscopic surgery （study group）. Intraoperative and postoperative clinical indicators, post-operative complication of the two groups were compared. Results Compared with before the operation, PA levels after the operation of the two groups were improved, and CRP level, PCT level were significantly reduced. There were significant statistical differences （P 〈 0.05）. The increase of PA in the control group was more significant than that in the observation group. CRP, PCT level of the observation group were decreased more significantly （P 〈 0.05）.Operation time differences of the two groups were not statistically significant （P 〉 0.05）. In the observation group, the amount of bleeding during operation was （48.3 ± 6.8） mL, Postoperative activity time was （12.5 ± 1.8） h, recovery time of gastrointestinal function was （3.0 ± 0.5） h, and discharge time was （5.1 ± 0.7） d.All of those were better than those of control group with （70.4 ± 9.7） mL,（68.2 ± 12.7）h, （4.6 ± 1.2）h,（9.7 ± 1.4）d. Differences were statistically significant （P 〈 0.05）. There were three kinds of three cases surgical complications in observation group with 10.0% incidence rate. There were five kinds of fourteen cases surgical complications in control group with 48.3% incidence rate. The difference was significant, and there was statistical significance （P 〈 0.05）. Conclusion Using laparoscopic in the diagnosis and treatment of adhesive intestinal obstruction, surgical trauma is small, it can reduce the amount of bleeding, inflammatory reaction is slight, complication is less, and it can help the patient to recover after operation.It is worthy of clinical promotion.