粘连性肠梗阻的手术治疗时机

Timing of the surgical treatment for adhesive intestinal obstruction

目的探讨粘连性肠梗阻患者的手术治疗时机。方法根据手术治疗时机,将44例粘连性肠梗阻患者分为早期手术组(28例)和后期手术组(16例),把第1、2次住院即行肠粘连松解术的肠梗阻患者作为早期手术组,将第3次住院或之后才行肠粘连松解术者作为后期手术组,观察比较2组患者预后情况。结果与后期手术组相比,早期手术组的术后住院时间明显缩短(P<0.05),术后肠道通畅情况更佳(P<0.05),肠梗阻术后5a复发率降低(P<0.05)。2组患者术后开始进食,进食后阳性症状以及肠梗阻术后1、3年复发率的比较,差异均无统计学意义(P>0.05)。结论对于粘连性肠梗阻患者,早期行腹腔镜下肠粘连松解术有利于缩短术后住院时长、早期恢复肠道正常功能、降低远期复发率。

Objective To explore the timing of surgical treatment for patients with adhesive intestinal obstruction.Methods According to the timing of surgical treatment,44 patients with adhesive intestinal obstruction were divided into an early operation group(28 cases)and a late operation group(16 cases).Intestinal obstruction patients who underwent laparoscopic intestinal adhesiolysis in the first two hospitalizations were regarded as the early surgery group,patients who underwent laparoscopic intestinal adhesiolysis in the 3rd hospitalization or after that were regarded as the late operation group.The prognosis of the two groups was observed and compared.Results Compared with the late operation group,the postoperative hospital stay in the early operation group was significantly shorter(P<0.05),postoperative bowel patency was better(P<0.05),the recurrence rate of intestinal obstruction 5 years after surgerywas reduced(P<0.05).There was no statistically significant difference between the two groups of patients in the postoperative start time of eating,the positive symptoms after eating,and the recurrence rate of intestinal obstruction in 1 and 3 years after surgery(P>0.05).Conclusion For patients with adhesive intestinal obstruction,early laparoscopic intestinal adhesiolysis is beneficial to shorten the length of postoperative hospital stay,to restore normal bowel function early,and to reduce the long-term recurrence rate.