经阑尾残端逆行肠内置管排列在粘连性肠梗阻再手术中的应用

目的 探讨防治广泛粘连致多次肠梗阻的手术方法.方法 将60例广泛粘连致多次肠梗阻患者随机分为两组,肠内排列组共23例,采用经阑尾残端逆行肠内置管排列的手术方法;肠外排列组共37例,采用肠外排列术(Noble肠排列法),并对其疗效及并发症进行比较.结果 肠内排列组23例中术后并发切口感染2例(8.70%).死亡1例(4.35%),无术后复发、痉挛性腹痛和不全梗阻等并发症发生,优良率95.65%(22/23).而肠外排列组37例中术后出现偶发性痉挛性腹痛11例(29.73%),不全梗阻6例(16.22%),术后切口感染3例(8.11%),优良率37.84%(14/37),术后复发3例(8.11%),死亡3例(8.11%).肠内排列组的术后并发症发生率、术后复发率、手术优良率方面明显优于肠外排列组(P<0.05).结论 经阑尾残端逆行肠内置管排列可以有效地预防和治疗广泛性肠粘连反复梗阻.

Application of retrograde intra-enteropexy through appendix stump for adhesive ileus

Objective To investigate operative method for preventing and treatment intestinal obstruction due to relapse adhesion.Methods Sixty patients with recurrent adhesive ileus treated by surgery were randomized into two groups,that was intra-enteropexy group and extra-enteropaxy group.Twenty-three patients in intra-enteropexy group were treated by retrograde intra-enteropaxy through appendix stump.Thirty-seven patients in the extra-enteropexy group were treated by Noble procedure.The effect and complication were compared.Results In the intra-enteropexy group,2 cases (8.70%) were complicated with incision infection,1 case was died (4.35%) and there was no relapsed,abdominal spastic pain and incomplete intestinal obstruction occurred.In the extra-enteropexy group,3 cases (8.11%) were complicated with incision infection,3 cases were died (8.11%),abdominal spastic pain were occurred in 11 cases (29.73%),incomplete intestinal obstruction were occurred in 6 cases(16.22%),and there were 3 cases run into relapse.Conclusion The retrograde intra-enteropexy through appendix stump is an effective method for preventing and treatment to adhesive ileus.