Study on multi-target mechanism of Radix et Rhizoma Rhei (Dahuang) and Semen Persicae (Taoren) on adhesion intestinal obstruction based on network pharmacology

Objective: To explore the mechanism of action of Radix et Rhizoma Rhei (Dahuang)(RERR) and Semen Persicae (Taoren)(SP) on adhesive intestinal obstruction (AIO). Methods: The main targets of the active ingredients of RERR and SP were filtered based on the traditional Chinese medicine system pharmacology analysis platform. Cytoscape 3.2.1 was applied to build the ingredient-target network of RERR and SP for AIO. Results: Fifteen active components were predicted from the RERR and SP herb pair, such as aloe-emodin, catechin, rhein, gibberellin (GA) 119, GA120 and GA121. These components were applied to 59 targets mainly involved in many biological processes such as signal transduction, anti-apoptosis, and inflammatory response involved in activating the immune effect. Conclusion: This study proposes the system pharmacology method and identifies the potent combination therapeutic mechanism of RERR and SP for AIO. This strategy will provide a new insight to the study of herb combinations.

Acupuncture and moxibustion for incomplete adhesive intestinal obstruction:A randomized controlled trial

Objective:To investigate the clinical efficacy of acupuncture and moxibustion for incomplete adhesive intestinal obstruction.Methods:A total of 100 patients with incomplete adhesive intestinal obstruction were randomly divided into an observation group and a control group,and there were 50 patients in each group.The control group was treated with routine western medicine treatment,while the observation group was treated with acupuncture and moxibustion therapy on the foundation of the routine western medicine treatment of the control group.Zhongwan(中脘CV12),Tianshu(天枢ST25),Zusanli(足三里ST36),Shangjiuxu(上巨虚ST37),Zhigou(支沟TE6),Dachangshu(大肠俞BL25),and Xiaochangshu(小肠俞BL27)were taken when acupuncture was performed.Moxibustion was performed with moxibustion box on abdomen after acupuncture.The time of abdominal pain relief,the first anal exhausting,the first defecation and intestines sound recovery,surgery conversion rate and clinical efficacy were observed in the two groups.Results:The time of abdominal pain relief,the first anal exhausting,the first defecation and intestines sound recovery in the observation group were all shorter than those of the control group.There were statistically significant differences between the two groups(all P<0.01).The surgery conversion rate of the observation group was lower than that of the control group,there was statistically significant difference between the two groups(P<0.01).The clinical efficacy of the observation group was superior to that of the control group,the difference between the two groups was statistically significant(P<0.05).Conclusions:Acupuncture and moxibustion therapy on the foundation of the routine western medicine treatment,which can reduce the surgical conversion rate and cut down the time of treatment,was superior to routine western medicine treatment on the clinical efficacy of incomplete adhesive intestinal obstruction.

Successful management of adhesion related small bowel ischemia without intestinal resection: A case report and review of literature

BACKGROUND Intraabdominal adhesions develop spontaneously or after an inflammatory process or surgical procedure in the abdomen.They are the most common cause of small bowel obstruction(SBO).SBO occasionally leads to intestinal ischemia(In Is)which can be a life-threatening condition that requires management as soon as possible.We herein report a case of SBO with In Is presented in our institution and treated without intestinal resection.CASE SUMMARY A 34-year-old man presented at the emergency department after a 12-h-onset diffuse abdominal pain,bloating and nausea.He had a history of traumatic right hepatectomy 11 years ago as well as adhesiolysis and resection of a long part of small bowel 2 years ago.An abdominal computed tomography(CT)showed dilated loops that led to the diagnosis of SBO.Due to deteriorating lactic acidosis,the patient was operated.Torsion of the small bowel around an adhesion led to2.30 m of ischemic ileum.After the application of N/S 40°C for 20 min,the intestine showed signs of improvement and it was decided to avoid resection and instead temporary close the abdomen with vacuum-pack technique.At the second-look laparotomy 48 h later,the intestine appeared normal.The patient was discharged on the 8 th post-op day in excellent condition.CONCLUSION In case of SBO caused by adhesions,extreme caution is needed if In Is is present,as the clinical signs are mild and you should rely for diagnosis in CT findings and lactate levels.Conservative surgical approach could reverse the effects of In Is,if performed quickly,so that intestinal resection is avoided and should be used even when minimum signs of viability are present.

Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention

Intra-abdominal adhesions following abdominal surgery represent a major unsolved problem. They are the first cause of small bowel obstruction. Diagnosis is based on clinical evaluation, water-soluble contrast followthrough and computed tomography scan. For patients presenting no signs of strangulation, peritonitis or severe intestinal impairment there is good evidence to support non-operative management. Open surgery is the preferred method for the surgical treatment of adhesive small bowel obstruction, in case of suspected strangulation or after failed conservative management, but laparoscopy is gaining widespread acceptance especially in selected group of patients. "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss current knowledge in modern diagnosis and evolving strategies for management and prevention that are leading to stratified care for patients.

Challenges in diagnosing adhesive small bowel obstruction

Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to identify such patients that will benefit from conservative treatment in order to prevent unnecessarily exposing them to the risks associated with surgical intervention,such as morbidity and further adhesion formation.For the remaining ASBO patients,timely surgical intervention is necessary to prevent small bowel strangulation,which may cause intestinal ischemia and bowel necrosis.While early identification of these patients is key to decreasing ASBO-related morbidity and mortality,the non-specific signs and laboratory findings upon clinic presentation limit timely diagnosis and implementation of appropriate clinical management.Combining the clinical presentation findings with those from other diagnostic imaging modalities,such as abdominal X-ray,computed tomography-scan and water-soluble contrast studies,will improve diagnosis of ASBO and help clinicians to better evaluate the potential of conservative management as a safe strategy for a particular patient.Nonetheless,patients who present with moderate findings by all these approaches continue to represent a challenge.A new diagnostic strategy is urgently needed to further improve our ability to identify early signs of strangulated bowel,and this diagnostic modality should be able to indicate when surgical management is required.A number of potential serum markers have been proposed for this purpose,including intestinal fatty acid binding protein andα-glutathione S transferase.On-going research is attempting to clearly define their diagnostic utility and to optimize their potential role in determining which patients should be managed surgically.

Value of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment: A prospective evaluation

AIM: Gastrografin is a hyperosmolar water-soluble contrast medium. Besides its predictive value for the need for operative treatment, a potential therapeutic role of this agent in adhesive small bowel obstruction has been suggested. This study aimed at evaluating the effectiveness of gastrografin in adhesive small bowel obstruction when conservative treatment failed. METHODS: Patients with adhesive small bowel obstruction were given trial conservative treatment unless there was fear of bowel strangulation. Those responded in the initial 48 h had conservative treatment continued. Patients who showed no improvement in the initial 48 h were given 100 mL of gastrografin through nasogastric tube followed by serial abdominal radiographs. Patients with the contrast appeared in large bowel within 24 h were regarded as having partial obstruction and conservative treatment was continued. Patients in which the contrast failed to reach large bowel within 24 h were considered to have complete obstruction and laparotomy was performed. RESULTS: Two hundred and twelve patients with 245 episodes of adhesive obstruction were included. Fifteen patients were operated on soon after admission due to fear of strangulation. One hundred and eighty-six episodes of obstruction showed improvement in the initial 48 h and conservative treatment was continued. Two patients had subsequent operations because of persistent obstruction. Forty-four episodes of obstruction showed no improvement within 48 h and gastrografin was administered. Seven patients underwent complete obstruction surgery. Partial obstruction was demonstrated in 37 other cases, obstruction resolved subsequently in all of them except one patient who required laparotomy because of persistent obstruction. The overall operative rate in this study was 10%. There was no complication that could be attributed to the use of gastrografin. CONCLUSION: The use of gastrografin in adhesive small bowel obstruction after unsuccessful conservative treatment is safe and reduces the need for suraical intervention

Risk Factors for the Development of Adhesive Small Bowel Obstruction after Abdominal and Pelvic Operations

Introduction: Adhesive small bowel obstruction (SBO) is a disease process that has been difficult to prevent. Mechanical barriers and chemical agents exist to disrupt the formation of adhesions following surgery but each associated with medical risk and financial burden. Identifying risk factors for developing SBO in patients post laparotomy would aid in the appropriate use of such agents. We hypothesize that there might be additional risk factors that are associated with a higher likelihood of SBO. Methods: A retrospective analysis from 2008 to 2012 was performed. Cases of SBO following previous laparotomy were compared to those without SBO. Results: 468 medical records were reviewed (57% male). Operations that caused the highest risks for SBO included gynecological, colorectal and hernia operations with prosthetic materials. 66% percent of patients underwent a prior abdominal or pelvic high-risk procedure. The average time from surgery to the development of SBO was 24 months (median 19 months). Patients who developed SBO had a median age of 58.4 years on initial surgery, average previous operative time of 4.3 hours, and an av-erage of two prior operations. For every hour of operative time, the odds of developing SBO increased by 33% (p 3 decreased the odds of SBO (p = 0.05). Conclusions: Longer operative times are associated with post-operative adhesive small bowel obstruction. Patients with an ASA score greater than or equal to 3 appear to have a reduced risk of adhesive small bowel obstruction.

茴香枳术汤对粘连性肠梗阻大鼠血浆内毒素的影响

目的:观察茴香枳术汤对粘连性肠梗阻大鼠血浆内毒素的影响,为深入探讨茴香枳术汤对粘连性肠梗阻微生态的作用机制提供实验依据。方法:从72只大鼠中,选择12只为正常组,其余60只制备大鼠粘连性肠梗阻模型,造模成功后随机分为假手术组,模型组,茴香枳术汤低(1.13 g/mL)、中(2.25 g、mL)、高(3.38 g/mL)剂量组,每组12只。各组给予对应药物治疗3天,末次给药后12 h股动脉取血,鲎试验偶氮基质显色法测定血浆内毒素含量;脱颈处死大鼠,取部分粘连组织行病理检查。结果:与正常组比较,模型组血浆内毒素含量显著增加(P<0.01);与模型组比较,假手术组及茴香枳术汤各剂量组血浆内毒素含量显著下降(P<0.01)。病理结果显示各治疗组肠壁形态逐渐恢复,炎症消退。结论:茴香枳术汤具有良好的治疗粘连性肠梗阻的作用,其作用机制与保护肠道微生态功能有关。

腹腔镜手术治疗粘连性肠梗阻预后情况分析

目的分析腹腔镜手术治疗粘连性肠梗阻预后情况。方法选取2018年5月—2023年5月天水市第一人民医院罹患粘连性肠梗阻疾病患者80例,按随机抽签法分为对照组、研究组,每组40例,对照组用开腹肠粘连松解术治疗,研究组用腹腔镜肠粘连松解术治疗,比较两组手术相关指标、炎症因子、免疫功能、生存质量、止痛药物使用率和粘连性肠梗阻复发率。结果研究组出血量比对照组少,研究组各项时间指标比对照组短,差异有统计学意义(P均<0.05)。治疗后,研究组C反应蛋白、白细胞介素-6均低于对照组,CD3^(+)、CD4^(+)、CD8^(+)水平均高于对照组,各生存质量项评分高于对照组,差异有统计学意义(P均<0.05)。研究组止痛药物使用率、粘连性肠梗阻复发率分别为10.00%、5.00%,均低于对照组,差异有统计学意义(χ^(2)=4.021、4.114,P均<0.05)。结论粘连性肠梗阻患者采取腹腔镜手术,能够优化患者预后效果,保障患者安全性。

数字减影血管造影引导下经侧孔快速交换法与传统鼻胃管减压治疗粘连性肠梗阻的疗效观察

目的 观察数字减影血管造影技术(DSA)引导下经侧孔快速交换法与传统鼻胃管减压治疗粘连性肠梗阻的临床疗效。方法 2019年1月~2021年1月本院收治的粘连性肠梗阻病人84例,按随机数字表法将病人分为研究组(42例)和对照组(42例),对照组予以传统鼻胃管减压治疗,研究组予以DSA引导下经侧孔快速交换法置管减压治疗。比较两组临床疗效、恢复指标(排气时间、拔管时间、进食时间、首次排便时间、腹痛缓解时间、X线气液平面消失时间、平均住院时间)、疼痛程度(VAS评分)、生活质量(SF-36评分)的差异。结果 等级资料秩和检验显示,两组临床疗效比较差异有统计学意义(P<0.05),研究组总有效率(92.86%)高于对照组(71.43%),差异有统计学意义(P<0.05)。研究组排气时间、拔管时间、进食时间、首次排便时间、腹痛缓解时间、X线气液平面消失时间、平均住院时间分别为(78.61±20.38)小时、(80.35±20.26)小时、(82.49±21.59)小时、(88.66±23.55)小时、(3.49±0.75)天、(4.31±1.16)天和(6.53±1.1)天,对照组分别为(101.36±31.56)小时、(104.33±28.85)小时、(108.41±25.55)小时、(141.32±35.49)小时、(6.05±1.29)天、(7.29±1.32)天和(10.01±2.06)天,两组比较,差异有统计学意义(P<0.05)。重复测量方差分析结示,两组治疗后1天、治疗后3天VAS评分与治疗前比较,明显降低,且治疗后3天的VAS评分低于治疗后1天,但研究组治疗后1天、治疗后3天的VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组出院时SF-36量表各因子得分与治疗前比较均升高,且研究组出院时SF-36量表各因子得分均高于对照组,差异有统计学意义(P<0.05)。结论 DSA引导下经侧孔快速交换法置管减压治疗粘连性肠梗阻可有效缓解病人疼痛程度,促进早期恢复,提高生活质量。

红藤汤加减灌肠治疗粘连性肠梗阻的临床疗效研究

目的探讨红藤汤加减灌肠治疗粘连性肠梗阻的临床疗效。方法选取2022年9月至2023年4月该院收治的86例粘连性肠梗阻患者作为研究对象,采用随机数字表法分为试验组与对照组,每组43例。对照组给予常规西药治疗,试验组在对照组基础上加用红藤汤加减灌肠治疗。比较两组治疗前及治疗3、7 d后的中医证候积分,患者血液标本中性粒细胞/淋巴细胞(NLR),比较两组疗效及不良反应发生率,比较两组恢复时间(胃管留置时间、腹痛缓解时间、腹胀缓解时间、首次排气时间、自行排便时间、气液平面消失时间、住院时间)及研究周期内因肠梗阻总住院次数。结果试验组治疗总有效率(93.02%)明显高于对照组(76.74%),差异有统计学意义(χ^(2)=4.440,P=0.035)。重复测量方差分析结果显示,两组治疗前及治疗3、7 d后的中医证候积分存在组间效应、时间效应、组间与时间的交互效应(P<0.05)。试验组胃管留置时间、腹痛缓解时间、腹胀缓解时间、首次排气时间、自行排便时间、气液平面消失时间、住院时间均短于对照组(P<0.05);试验组研究周期内因肠梗阻总住院次数少于对照组(P<0.05)。重复测量方差分析结果显示,两组治疗前及治疗3、7 d后的NLR存在组间效应、时间效应、组间与时间的交互效应(P<0.05)。两组不良反应发生率比较,差异无统计学意义(χ2=0.387,P=0.534)。结论粘连性肠梗阻采用红藤汤加减灌肠治疗,能有效调节机体NLR,加快临床症状缓解,提高临床疗效。

粘连性肠梗阻应用腹腔镜肠粘连松解术治疗的效果及对应激反应的影响

目的探讨应用腹腔镜肠粘连松解术治疗粘连性肠梗阻的效果及对应激反应的影响。方法选取2021年2月—2023年2月莱西市第三人民医院收治的50例粘连性肠梗阻患者为研究对象,按照随机数表法分为两组,每组25例。对照组采用开腹肠粘连松解术治疗,观察组采用腹腔镜肠粘连松解术治疗。比较两组手术指标、术后康复指标、应激反应指标、术后并发症发生率。结果较之对照组,观察组术中出血量更少,手术时间、术后住院及肠功能恢复时间更短,术后疼痛评分更低,差异有统计学意义(P均<0.05);观察组的术后血清白细胞计数、C反应蛋白、白细胞介素-6水平均低于对照组,差异有统计学意义(P均<0.05);观察组并发症发生率为0,低于对照组的16.00%,差异有统计学意义(χ^(2)=4.348,P=0.037)。结论粘连性肠梗阻患者予以腹腔镜肠粘连松解术治疗,有助于降低手术创伤,避免术后并发症,减轻术后疼痛,抑制术后应激反应,缩短恢复时间。

通腑泻热灌肠合剂治疗小儿粘连性肠梗阻的疗效观察

目的 探讨通腑泻热灌肠合剂治疗小儿粘连性肠梗阻(AIO)的效果。方法 选取82例AIO患儿,利用简单随机分组法将患儿分为常规组(使用常规治疗)和灌肠组(在常规治疗基础上使用通腑泻热灌肠合剂治疗),每组41例。比较两组患儿的临床疗效,临床症状积分,胃肠功能恢复情况,血清炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]以及不良事件发生率。结果 灌肠组患儿治疗总有效率为92.68%,高于常规组的73.17%,差异有统计学意义(P<0.05)。治疗后3、5、7 d,两组患儿的临床症状积分均较治疗前降低,且灌肠组治疗后3、5、7 d临床症状积分(17.28±4.85)、(9.24±2.08)、(3.87±0.25)分均较常规组的(21.46±4.99)、(15.23±3.31)、(7.95±1.14)分低,差异有统计学意义(P<0.05)。治疗后,灌肠组首次排气时间(2.29±0.54)d、首次排便时间(3.35±0.83)d、胃管拔除时间(5.38±1.18)d、住院时长(7.34±1.14)d均较常规组的(2.68±0.66)、(4.28±1.08)、(6.19±1.21)、(8.64±1.02)d更短,差异有统计学意义(P<0.05)。治疗后,两组患儿CRP、IL-6、TNF-α水平均较治疗前降低,且灌肠组患儿CRP(5.39±1.59)mg/L、IL-6(23.58±4.69)pg/ml、TNF-α(18.62±4.24)ng/L均低于常规组的(9.44±2.77)mg/L、(31.28±5.36)pg/ml、(31.26±5.86)ng/L,差异有统计学意义(P<0.05)。两组患儿不良事件发生率比较,差异无统计学意义(P>0.05)。结论 通腑泻热灌肠合剂治疗小儿AIO疗效显著,可有效减轻患儿临床症状,缩短疾病恢复时间,且安全性高。

小肠内置管肠排列术治疗粘连性肠梗阻52例临床研究

目的观察小肠内置管排列术治疗粘连性肠梗阻的临床效果。方法回顾性分析52例严重肠粘连性肠梗阻或其他类型复杂型肠梗阻而行小肠内置管排列术患者的临床资料。结果 52例患者手术后无死亡和肠瘘发生,术后有8例发生切口感染,45例患者随访时间6个月到5年不等,均未再次发生肠梗阻。结论小肠内置管法是治疗严重粘连性肠梗阻,预防再发肠梗阻并减少肠瘘发生的简便安全有效的手段。

粘连性肠梗阻的多层螺旋CT诊断及其临床应用价值

目的探讨多层螺旋CT对粘连性肠梗阻的诊断作用。方法对35例手术证实为粘连性肠梗阻患者的术前全腹多层螺旋CT征象进行回顾性分析,并以手术、病理结果为标准,评价CT诊断的准确性。结果35例患者CT均确定了梗阻的存在。31例单发梗阻CT均准确确定了梗阻部位,4例多发梗阻者CT确定了11处梗阻中的9处。26例非癌性粘连中23例在CT上均有相应的CT征象支持粘连性肠梗阻的诊断;9例癌性粘连中5例CT发现癌性粘连的直接征象,2例提示癌灶复发或淋巴结转移。根据CT征象判断绞窄性肠梗阻的敏感性93.3%,特异性87.5%,准确性为91.4%。结论多层螺旋CT可较为全面地评价粘连性肠梗阻,对于指导临床诊疗有较大帮助。

生长抑素联合肠梗阻导管治疗粘连性肠梗阻的临床研究

目的探讨生长抑素联合肠梗阻导管治疗粘连性肠梗阻的临床疗效。方法选取首都医科大学潞河数学医院2010年1月～2012年8月收治的粘连性肠梗阻患者107例,随机分为四组,28例患者采用鼻胃管治疗为对照Ⅰ组,26例患者采用肠梗阻导管治疗为对照Ⅱ组,26例患者采用生长抑素联合鼻胃管治疗为对照Ⅲ组,27例患者采用生长抑素联合肠梗阻导管治疗为观察组。比较四组患者治疗后的临床指标改善情况、中转手术情况、临床疗效、患者满意度。结果在腹胀痛缓解时间和恢复排气时间上,对照Ⅰ组、对照Ⅱ组、对照Ⅲ组、观察组依次呈现出了明显的递减趋势;在胃肠减压量上,对照Ⅱ组、观察组、对照Ⅰ组、对照Ⅲ组依次呈现出了明显的递减趋势,组间差异均有统计学意义(P<0.05)。在中转手术情况上,对照Ⅰ组、对照Ⅱ组、对照Ⅲ组、观察组依次呈现出了递减趋势(P=0.032),观察组的中转手术率明显低于对照Ⅰ组和对照Ⅱ组;在患者满意度上,对照Ⅰ组、对照Ⅱ组、对照Ⅲ组、观察组依次呈现出了递增趋势(P=0.004),观察组和对照Ⅲ组患者满意度明显高于对照Ⅰ组;在临床疗效上,对照Ⅰ组、对照Ⅱ组、对照Ⅲ组、观察组依次呈现出了递增趋势(P=0.032),观察组的总有效率明显高于对照Ⅰ组和对照Ⅱ组,差异均有统计学意义(P<0.05)。结论生长抑素联合肠梗阻导管治疗粘连性肠梗阻具有显著的临床疗效,可以明显改善患者的临床指征,提高保守治疗的成功率,值得临床推广使用。

针刺对粘连性肠梗阻大鼠肠黏膜超微结构的影响

目的:探讨针刺对粘连性肠梗阻大鼠预防作用的机理。方法:建立粘连性肠梗阻大鼠模型,对大鼠肠黏膜的超微结构进行研究。结果:术后小肠黏膜上皮细胞微绒毛减少,线粒体和粗面内质网明显减少,炎性细胞浸润增多。针刺能明显改善肠梗阻时小肠组织超微结构的损伤,促进线粒体和粗面内质网功能和形态恢复。结论:针刺能够改善术后肠道黏膜上皮细胞异常的超微结构,增强肠黏膜的防御屏障功能。

贝伐珠单抗联合化疗治疗晚期卵巢癌所致粘连性肠梗阻的疗效观察

目的:观察腹腔灌注贝伐珠单抗联合化疗治疗卵巢癌所致粘连性肠梗阻的临床疗效,分析腹腔内血管内皮生长因子(VEGF)水平对贝伐珠单抗治疗卵巢癌腹腔粘连的临床意义。方法:将62例卵巢癌伴恶性不完全性肠梗阻患者随机分为实验组(n=32)和对照组(n=30),均用奥曲肽(60 mg/d连续3天)全身治疗,3周重复1次;同时腹腔内给予灌注化疗,每3周重复1次,连续治疗2周期。对照组给予吉西他滨和卡铂腹腔灌注治疗,实验组在上述治疗基础上联合贝伐珠单抗(5 mg/kg)治疗。评价患者疗效、不良反应。酶联免疫吸附法(ELISA)检测62例患者治疗前、后腹腔中VEGF水平。结果:实验组的有效率为87.50%,对照组为43.33%,差异有统计学意义(P<0.05)。实验组和对照组患者耐受良好,不良反应无明显差异。治疗后对照组腹水VEGF水平为(139.89±10.89)pg/mL,明显低于治疗前的(310.59±13.63)pg/mL(P<0.05);实验组治疗后腹水VEGF水平为(81.57±4.71)pg/mL,明显低于治疗前的(309.67±11.02)pg/mL(P<0.05)。治疗后VEGF水平实验组较对照组下降更为显著(P<0.05)。结论:贝伐珠单抗联合化疗治疗晚期卵巢癌粘连性肠梗阻优于单纯腹腔灌注化疗,不良反应较少,安全性耐受性好。

针刺对粘连性肠梗阻大鼠肠黏膜免疫屏障功能的保护作用

目的:探讨针刺对粘连性肠梗阻大鼠预防作用的免疫学机理。方法:75只SD大鼠随机分为正常组、假手术组、模型组、灌肠组、针刺组,观察针刺对粘连肠梗阻大鼠肠黏膜形态学、肠组织干湿回肠比和sIgA含量影响。结果:4、14、28天模型组可见小肠绒毛水肿,固有层血管充血,肠腔炎性渗出,灌肠组和针刺组仅见绒毛水肿。3个实验组各时段湿干比较假手术组升高,14、28天针刺组较模型组低(P<0.05)。模型组各时段sIgA均较假手术组明显降低(P<0.01),经针刺后,sIgA逐渐提高,28天针刺组效果优于灌肠组。结论:针刺能够提高或促进sIgA的合成和分泌,进而增强肠道局部免疫,有效保护肠道黏膜的完整性,对肠黏膜的免疫屏障功能损伤起一定的保护作用。

腹腔镜治疗粘连性肠梗阻12例

目的 探讨腹腔镜治疗粘连性肠梗阻的方法、疗效及部分改进方法的实际意义。方法 总结 1998～ 2 0 0 3年期间应用腹腔镜微创技术治疗粘连性肠梗阻 12例 ,分析其手术适应证、手术方法及术后疗效。结果 12例粘连性肠梗阻患者经腹腔镜确诊后 ,11例行腹腔镜粘连松解术 ,1例辅以小切口开腹手术。术后随访 6个月至 2年 ,均无复发。中转开腹率为 8.3%。结论 只要严格掌握手术适应证、熟练掌握手术技巧、仔细操作 ,腹腔镜是现阶段治疗粘连性肠梗阻较为理想的、最小的侵入性手术方法 ,治愈率高 ,复发率低 ,符合现代外科的微创发展潮流。