小肠内排列术与开腹粘连松解术治疗急性广泛粘连性肠梗阻患者的效果比较

Comparison of effects of small intestinal alignment and open adhesiolysis in treatment of acute extensive adhesive intestinal obstruction

目的:比较小肠内排列术与开腹粘连松解术治疗急性广泛粘连性肠梗阻患者的效果。方法:选取2018年10月至2021年10月该院收治的120例急性广泛粘连性肠梗阻患者进行前瞻性研究,采用随机数字表法将其分为对照组和观察组各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,比较两组围术期指标(手术时间、术中出血量、下床活动时间、肛门首次排气时间、腹胀消失时间)水平、治疗总有效率和术后1周并发症发生率。结果:观察组手术时间、下床活动时间、肛门首次排气时间和腹胀消失时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组治疗总有效率比较,差异无统计学意义(P>0.05);观察组术后1周并发症发生率为6.67%(4/60),低于对照组的21.67%(13/60),差异有统计学意义(P<0.05)。结论:小肠内排列术与开腹粘连松解术治疗急性广泛粘连性肠梗阻患者的治疗总有效率相当,但小肠内排列术可降低围术期指标水平和术后并发症发生率,效果优于开腹粘连松解术治疗。

Objective:To compare effects of small intestinal alignment and open adhesiolysis in treatment of acute extensive adhesive intestinal obstruction.Methods:A prospective study was conducted on 120 patients with acute extensive adhesive intestinal obstruction admitted to the hospital from October 2018 to October 2021.They were divided into control group and observation group by using the random number table method,60 cases in each.The control group was treated with open adhesiolysis,while the observation group was treated with small intestinal alignment.The level of perioperative indicators(operation time,intraoperative blood loss,out-of-bed time,exhaust time,abdominal distension disappearance time),the total effective rate of treatment,and the incidence of complications in the first week after the surgery were compared between the two groups.Results:The operation time,the out-of-bed time,the exhaust time and the abdominal distension disappearance time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total effective rate between the two groups(P>0.05).The incidence of postoperative complications in the observation group was 6.67%(4/60),which was lower than 21.67%(13/60)in the control group,and the difference was statistically significant(P<0.05).Conclusions:The total effective rates of small intestinal alignment and open adhesiolysis in the treatment of the patients with acute extensive adhesive intestinal obstruction are equivalent;however,small intestinal alignment can reduce the levels of perioperative indicators and the incidence of postoperative complications.Moreover,it is superior to open adhesiolysis.