粘连性肠梗阻的泛影葡胺造影和腹腔镜松解术治疗

目的 探讨泛影葡胺胃肠道造影法，应用于粘连性肠梗阻诊断中的准确性，并且评价腹腔镜肠粘连松解术的临床疗效。方法 对保守治疗2天无明显效果的42例粘连性肠梗阻患者，给予口服76％泛影葡胺，进行胃肠道造影，并综合其他临床指征以判断是否需要进行手术，其中的23例患者接受了腹腔镜肠粘连松解术治疗。对比各项临床结果，总结泛影葡胺胃肠道造影法的准确性，以及腹腔镜肠粘连松解术的疗效。结果 数据统计显示，泛影葡胺溶液是否进入结肠与最终是否手术之间具有很强的一致性（P〈0．01）。应用腹腔镜所有患者均成功实施粘连松解术，解除肠梗阻，未出现手术并发症，随访1年内未见有复发病例。结论 以泛影葡胺溶液在24小时内能否到达大肠，作为判断完全性肠梗阻的标准，在临床应用中的准确率非常高。腹腔镜松解术微创治疗粘连性肠梗阻，安全实用、疗效可靠，是临床处理此类症状的理想手段。

Gastrografin Imaging and Laparoscopic Adhesiolysis for Adhesive ileus

Objective To determine the accuracy of gastrografin imaging in gastrointestinal obstruction and the effect of laparoscopic adhesiolysis for adhesive ileus. Methods After 2 days of conservative therapy, 42 patients with adhesive ileus indicated no improvement and received 76% of gastrografin imaging. Twenty-three cases with ileus were performed with laparoscopic adhesiolysis. The results of gastrografin imaging and adhesiolysis were summarized and compared. Results It was showed that whether gastrografin entered into colon or not was correlated closely with performance of adhesiolysis or not(P<0.01). After laparoscopic adhesiolysis, the patients had no complications and no recurrent obstruction during the follow-up period of 1 year. Conclusions The clinical application of gastrografin imaging for intestinal obstruction is efficient and reproducible. If it doesn't enter into colon in 24 hours, laparoscopic adhesiolysis should be performed, which is an ideal approach for this kind of symptom with minimal invasiveness.