反复发作不全性粘连性肠梗阻腹腔镜探查及治疗60例分析

目的探讨反复发作不全性粘连性肠梗阻腹腔镜探查及治疗临床价值。方法随机选取2011年5月至2013年9月接受治疗的粘连性肠梗阻患者共120例作为本次研究对象,根据入院时间将患者分为腹腔镜组和开腹组,各60例。选择SPSS18.0进行数据统计,术中术后指标、疼痛评分等采用均数±标准差(x珋±s)表示,t检验;并发症发生率、治愈率计数资料采用χ2检验;满意率等级资料采用秩和检验(Wilcoxon两样本比较法)进行比较,当P0.05时差异具有统计学意义。结果腹腔镜组患者手术时间、术后下床活动的时间,术中出血量,明显少于开腹组(P0.05);且肠蠕动恢复和拔导尿管时间、住院天数,明显短于开腹组(P0.05)。腹腔镜组疼痛指数、愈合时间明显低于开腹组,且手术后治愈率(90.0%)明显高于开腹组(66.7%),两组比较差异有统计学意义(t=57.179,P=0.000;t=19.713,P=0.000;χ~2=9.624,P=0.002)。腹腔镜组患者并发症的发生率为10.0%,明显低于开腹组33.3%(χ~2=13.141,P0.05);腹腔镜组患者的满意率高达88.4%,明显高于开腹组(u=3.824,P0.05)两组比较差异均有统计学意义。结论对于反复发作的不全性的粘连性肠梗阻患者采用腹腔镜进行治疗的效果显著,并发症少,恢复快,显著提高了患者的生活质量,值得在临床广泛推广使用。

Laparoscopic exploration and treatment for 60 patients with recurrent episodes of incomplete adhesive intestinal obstruction

Objective To investigate the results of laparoscopic exploration and treatment of recurrent incomplete adhesive intestinal obstruction . Methods 120 patients with intestinal obstruction treated in our hospital from May 2011 to September 2013 were enrolled in this study .The patients were divided into a laparoscopic group and an open group according to the time of admission , with 60 patients in each group.SPSS18.0 was used for data analysis , and the postoperative indexes and pain scores were expressed as mean ±SD and Student ’ s t test was used for data evaluation .The incidence of complications and the cure rate were tested by the Chi-square test.The satisfaction rates were compared using Wilcoxon ’ s rank-sum test.P<0.05 was considered statistically significant . Results of Operative time, postoperative off-bed time, and bleeding volume in the laparoscopic group were significantly different from those in the open group (P<0.05), and the recovery of intestinal peristalsis , the time of catheter removal and the length of hospital stay were also significantly shorter than those in the open group (P<0.05).The pain index and healing time of the laparoscopic group were significantly lower than those in the open group , and the cure rate (90.0%) was significantly higher than that (66.7%) in the open group.The differences between the two groups were statistically significant (t=57.179, P=0.000;t=19.713, P=0.000;χ2 =9.624, P=0.002). The incidence of complications in the laparoscopic group was 10.0%, which was significantly lower than that (33.3%) in the open group (χ2 =13.141, P<0.05).The satisfactory rate in thelaparoscopic group was 88.4%, which was significantly higher than that in the open group (u=3.824, P<0.05). Conclusion For patients with recurrent adhesive intestinal obstruction , laparoscopic treatment was effective, with fewer complications and faster recovery .Therefore, it is worth popularizing in clinical treatment .