腹腔镜肠粘连松解术联合奥曲肽治疗腹部手术后急性粘连性肠梗阻的疗效

Efficacy of laparoscopic enterolysis combined with octreotide in the treatment of acute adhesive intestinal obstruction after abdominal surgery

目的探讨腹腔镜肠粘连松解术联合奥曲肽治疗腹部手术后急性粘连性肠梗阻的疗效。方法选取2015年1月~2018年1月腹部手术后粘连性肠梗阻患者68例,随机分为观察组和对照组。两组患者给予禁食、胃肠减压、抗感染、胃肠外营养、维持水电解质及酸碱平衡等基础治疗。对照组患者予以腹腔镜肠粘连松解术。观察组患者在对照组基础上再加奥曲肽针0.1 mg皮下注射,每8小时1次,直至肛门恢复正常排便排气功能。观察并记录两组患者治疗后胃肠功能恢复情况及术后住院时间,并比较其临床疗效。结果观察组患者术后胃肠减压引流量、肠蠕动恢复时间和肛门恢复排气时间和术后住院时间明显少于或短于对照组(P<0.05);术后7 d,观察组患者临床总有效率高于对照组(χ2=4.22,P<0.05)。结论腹腔镜肠粘连松解术联合奥曲肽治疗腹部手术后急性粘连性肠梗阻的疗效较确切,更能促进胃肠道蠕动,加快胃肠功能的恢复,缩短术后住院时间。

Objective To investigate the efficacy of laparoscopic enterolysis combined with oetreotide in the treatment of acute adhesive intestinal obstruction after abdominal surgery. Methods A total of 68 patients with adhesive intestinal obstruction after abdominal surgery from January 2015 to January 2018 were selected. They were randomly divided into observation group and control group. The two groups of patients were given basic treatment methods such as fasting, gastrointestinal decompression, anti-infection, parenteral nutrition, and maintenance of water-electrolyte and acid-base balance. Patients in the control group were given laparoseopic enterolysis. Patients in the observation group were given subcutaneous injection of octreotide of 0.1 mg for every 8 hours per dose on the basis of the control group, until the anus returned to normal defecation and passage of gas. The recovery of gastrointestinal function and postoperative length of hospital stay in both groups after treatment were observed and recorded, and its clinical efficacy was compared. Results The postoperative gastrointestinal decompression drainage, recovery time of intestinal peristalsis, recovery time of passage of gas and postoperative length of hospital stay were significantly less or shorter in the observation group than those in the control group（P〈0.05）; 7 days after surgery, the total clinical efficacy in the observation group was higher than that in the control group（χ^2=4.22, P〈0.05）. Conclusion Laparoscopic enterolysis combined with octreotide is more effective in the treatment of acute adhesive intestinal obstruction after abdominal surgery, which can promote gastrointestinal motility, accelerate the recovery of gastrointestinal function, and shorten the length of postoperative hospital stay.