小肠内排列术与开腹粘连松解术治疗中度粘连性肠梗阻的临床效果及对前白蛋白、炎症因子的影响

Clinical effect of small intestinal arrangement and open adhesion loosing in the treatment of moderate adhesive intestinal obstruction and its effects on prealbumin and inflammatory factors

目的观察小肠内排列术与开腹粘连松解术治疗中度粘连性肠梗阻的临床效果。方法将120例中度粘连性肠梗阻患者随机分为对照组与观察组,各60例。对照组采用开腹粘连松解术治疗,观察组采用小肠内排列术治疗。比较两组患者的临床疗效。结果观察组手术时间、住院时间、下床活动时间、肛门排气时间均显著短于对照组,术中出血量显著少于对照组(P<0.05)。治疗后,两组患者的PA水平均升高,IL-6、IL-4及TNF-α水平均降低,且观察组IL-6、TNF-α水平显著低于对照组,IL-4、PA水平显著高于对照组(P<0.05)。观察组患者的并发症总发生率、复发率均显著低于对照组(P<0.05)。结论采用小肠内排列术治疗中度粘连性肠梗阻,可显著减轻术后疼痛及炎症程度,提高血清PA水平,减少并发症,值得临床推广应用。

Objective To observe the clinical effect of small intestinal arrangement and open adhesion loosing in thetreatment of moderate adhesive intestinal obstruction. Methods One hundred and twenty patients with moderate adhesiveintestinal obstruction were randomly divided into control group and observation group, with 60 cases in each group. Thecontrol group was treated with open adhesion loosing, the observation group was treated with small intestinal arrangement.The clinical effects of the two groups were compared. Results The operative time, length of stay time, ambulation and anusexhaust in the observation group were shorter than those in the control group, the intraoperative blood loss amount was lessthan that in the control group（P〈0.05）. After treatment, the level of PA in the two groups increased, the levels of IL-6, IL-4 and TNF-α decreased, and the levels of IL-6 and TNF-α in the observation group were significantly lower than those inthe control group, the levels of IL-4 and PA were significantly higher than those in the control group （P〈0.05）. The totalincidence of complications and recurrence rate in the observation group were significantly lower than those in the controlgroup （P〈0.05）. Conclusion The small intestinal arrangement in the treatment of moderate adhesion intestinal obstructioncan significantly mitigate postoperative pain and degree of inflammation, improve the levels of serum PA, reducecomplications, and it is worthy of clinical popularization and application.