术后粘连性肠梗阻手术指征的多因素研究

Study on the Multiple Factors of Postoperative Adhesive Intestinal Obstruction

目的研究并探讨术后粘连性肠梗阻手术指征的相关影响因素,为术后粘连性肠梗阻是否进行手术治疗提供判断依据。方法于2014年1月—2015年12月,选取该院收治的60例腹部手术后粘连性肠梗阻患者作为此次研究的对象,按照治疗方式分为A组(保守治疗)、B组(手术治疗),对患者选择手术治疗的相关因素进行单因素分析、多因素Logistics线性回归分析。结果单因素分析中,A组、B组的肠粘连次数(>1次分别有12例、17例)、保守治疗时间(超过3 d分别有11例、17例)、体温(超过37.5℃分别有13例、18例)、腹部可触及肿大肠襻(15例、21例)、持续腹痛(14例、22例)、反跳痛阳性(13例、22例)、腹腔积液(9例、25例)、白细胞计数过高(13例、19例)进行比较,差异有统计学意义(P<0.05);经多因素Logistics线性回归分析后得出,肠粘连次数、保守治疗时间、腹部可触及肿大肠襻、持续腹痛、反跳痛阳性、腹腔积液、白细胞计数是导致术后粘连性肠梗阻患者选择手术治疗的主要因素。结论腹部手术后粘连性肠梗阻患者选择手术治疗需严格把握手术指征,综合考虑多方面因素。

Objective To investigate and discuss the related influencing factors of postoperative adhesive intestinal ob- struction, and to provide the basis for the surgical treatment of postoperative adhesive intestinal obstruction. Methods In January 2014 to December 2015, 60 cases of patients with adhesive intestinal obstruction after abdominal surgery in the hospital were selected as the research object, according to the summary, the patients were divided into group A （conservative treatment） and group B （surgical treatment）, the related factors on surgical treatment of patients were ana- lyzed by univariate analysis and multivariate Logistics regression analysis. Results In univariate analysis, the intestinal adhesion times （〉1 times were 12 cases, 17 cases）, conservative treatment time （more than 3 days were 11 cases, 17 cases）, temperature （more than 37.5 degrees were 13 cases, 18 cases）, abdominal enlargement intestinal loops （15 cases, 21 cases）, sustained abdominal pain （14 cases, 22 cases）, rebound tenderness （13 cases, 22 cases）, ascites （9 cases, 25 cases）, white blood cell count was too high （13 cases, 19 cases） were compared between two groups, the differences were statistically significant（P〈0.05）; After the linear regression analysis of multiple factors Logistics, intestinal adhe- sion times, conservative treatment time, abdominal swelling, abdominal pain, intestinal loop sustained rebound tender- ness, abdominal effusion, white blood cell count were main factors to cause postoperative adhesive intestinal obstructionafter surgical treatment. Conclusion The adhesive ileus after abdominal surgery in patients with surgical treatment, should be strictly grasp the surgical indications, considering various factors.