腹腔镜肠粘连松解术治疗粘连性肠梗阻的效果及对胃肠功能恢复时间的影响

Effect of laparoscopic intestinal adhesion lysis in the treatment of adhesive intestinal obstruction and its influence on the recovery time of gastrointestinal function

目的探究腹腔镜肠粘连松解术治疗粘连性肠梗阻的效果及对胃肠功能恢复时间的影响。方法选取2018年6月至2019年9月本院收治的90例粘连性肠梗阻患者作为研究对象,按照治疗方法的不同将其分为对照组(45例,开腹肠粘连松解术)和观察组(45例,腹腔镜肠粘连松解术)。比较两组的治疗效果。结果观察组的术中出血量少于对照组,手术时间、胃肠功能恢复时间、首次下床活动时间、尿管拔除时间、住院时间短于对照组,差异具有统计学意义(P<0.05)。术后1 d,观察组的皮质醇(COR)、肾上腺素(E)、去甲肾上腺素(NE)水平及心率低于对照组,差异具有统计学意义(P<0.05)。术后1周,观察组的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)水平低于对照组,前白蛋白(PA)水平高于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率及1年复发率均低于对照组,差异具有统计学意义(P<0.05)。结论腹腔镜粘连松解术治疗粘连性肠梗阻的效果显著,可改善应激指标和炎症因子水平,促进患者术后尽快恢复,值得推广。

Objective To explore the effect of laparoscopic intestinal adhesion lysis in the treatment of adhesive intestinal obstruction and its influence on the recovery time of gastrointestinal function.Methods From June 2018 to September 2019,90 patients with adhesive intestinal obstruction admitted in our hospital were selected as the research objects.According to different treatment methods,the patients were divided into control group(45 cases,open intestinal adhesion lysis)and observation group(45 cases,laparoscopic intestinal adhesion lysis).The therapeutic effects of the two groups were compared.Results The intraoperative blood loss in the observation group was less than that in the control group,the operation time,recovery time of gastrointestinal function,first ambulation time,catheter removal time and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).At 1 d after operation,the levels of cortisol(COR),epinephrine(E),norepinephrine(NE)and heart rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At 1 week after operation,the levels of tumor necrosis factor-α(TNF-α),C-reaction protein(CRP)and procalcitonin(PCT)in the observation group were lower than those in the control group,the level of prealbumin(PA)was higher than that in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications and one year recurrence rate in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Laparoscopic intestinal adhesion lysis in the treatment of adhesive intestinal obstruction has remarkable effect,it can improve the stress indexes and inflammatory factor levels,promote patients recover as soon as possible,which is worthy of promotion.