腹腔镜技术在顽固性粘连性肠梗阻治疗中的应用

发布时间：2018-05-04 01:05

本文选题：腹腔镜手术 + 顽固性　；参考：《实用医学杂志》2017年02期

【摘要】：目的:探讨腹腔镜技术在顽固性粘连性肠梗阻治疗中的疗效及其安全性。方法:回顾性病例对照分析我科2011年1月至2016年1月,发作3次及以上的顽固性粘连性肠梗阻患者68例,经保守治疗缓解后予腹腔镜手术干预和继续随访观察,分腹腔镜手术组(32例)和观察组(36例),对比两种治疗方式复发率和安全性。结果:随访半年以上,腹腔镜手术组复发率明显低于观察组(18.8%vs.77.8%P0.05);腹腔镜组:肠粘连病理分型主要为混合型、片状粘连型及索带卡压型,随访发现:混合型复发率(66.7%,4/6例)明显高于片状粘连型(10.0%,1/10例)以及索带卡压型(6.3%,1/16例)。结论:在顽固性粘连性肠梗阻的缓解期,腹腔镜手术是安全可行的,能有效降低顽固性粘连性肠梗阻复发率,手术疗效与粘连类型密切相关。
[Abstract]:Objective: to evaluate the efficacy and safety of laparoscopy in the treatment of intractable adhesive intestinal obstruction. Methods: from January 2011 to January 2016, 68 patients with intractable adhesive intestinal obstruction with 3 or more episodes were analyzed retrospectively. The patients were treated with laparoscopic intervention and follow-up after conservative treatment. There were 32 cases of laparoscopic operation group and 36 cases of observation group. The recurrence rate and safety of two treatment methods were compared. Results: the recurrence rate of laparoscopic operation group was significantly lower than that of observation group (18.8vs.77.8v 路77.8g / kg) for more than half a year, and the pathological types of intestinal adhesions in laparoscopic group were mainly mixed type, lamellar adhesion type and cord band compression type. The results of follow-up showed that the recurrence rate of mixed type was significantly higher than that of lamellar adhesion type (66.7% 6 / 6) and 10 cases of lamellar adhesion type (10.0% / 10 cases) and 16 cases of cord band compression type (6.3%). Conclusion: laparoscopic surgery is safe and feasible in the remission stage of intractable adhesive intestinal obstruction and can effectively reduce the recurrence rate of refractory adhesive intestinal obstruction. The operative effect is closely related to the type of adhesion.
【作者单位】：广州中医药大学第二附属医院(广东省中医院)胃肠外科;广东省中医院胃肠外科;

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