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1、腹腔镜粘连松解术治疗粘连性肠梗阻的效果观察[摘要]目的评价腹腔镜粘连松解术治疗粘连性肠梗阻的临床效果及安全性。方法选取2010年6月〜2013年5月本院收治的粘连性肠梗阻患者40例,随机分为观察组和对照组,其中观察组20例,采用腹腔镜粘连松解术治疗,对照组20例,采用常规开腹手术治疗,观察并比较两组的手术时间、术中出血量、腹痛消失时间、胃肠功能恢复时间及并发症发生率。结果观察组的手术时间、腹痛消失时间及胃肠功能恢复时间均短于对照组,术中出血量少于对照组,差异有统计学意义(PV0.05)。观察组的并发
2、症发生率为10%,对照组的并发症发生率为35%,两组比较差异冇统计学意义(PV0.05)。结论采用腹腔镜粘连松解术治疗粘连性肠梗阻不仅可有效解除粘连,而且有创伤小、出血量少、患者恢复快、并发症发生率低等优点,并可预防再粘连的发生,值得临床推广应用。[关键词]腹腔镜;粘连松解术;肠梗阻;疗效[中图分类号]R616.2:文献标识码]B[文章编号]1674-4721(2014)05(b)-0171-02Effectobservationoflaparoscopicadhesiolysisinthetrea
3、lmentofintestinalobstructionHUWeiDepartmentofGeneralSurgery,People'sHospitalofWushanCountyinChongqingCity,Wushan404700,China[Abstract]ObjectiveToevaluatetheclinicalefficacyandsaftyoflaparoscopicadhesiolysisinthetreatmentofintestinalobstruction.Methods4
4、0casesofpatientswithintestinalobstructionfromJune2010toMay2013inourhospitalwereselectedandrandomlydividedintoobservationgroupandcontrolgroup.Laparoscopicadhesiolysiswasusedinobservationgroup(20cases)andconventionalopensurgerywasusedincontrolgroup(20cas
5、es).0perativetime,bloodloss,abdominalpainduration,gastrointestinalfunctionrecoverytimeandtheincideneerateofcomplicationintwogroupswascomparedrespectively.ResultsOperativetime,abdominalpainduration,gastrointestinalfunctionrecoverytimeinobservationgroupw
6、asshorterthanthatincontrolgrouprespectively,bloodlossinobservationgroupwaslessthanthatincontrolgroup,withstatisticaldifference(PV0.05).Theincidencerateofcomplicationinobservationgroupwas10%,theincidencerateofcomplicationincontrolgroupwas35%,withstatist
7、icaldifferenee(P<0.05)•ConclusionLaparoscopicadhesiolysisinthetreatmentofintestinalobstructionnotonlycaneffectivelyrelieveadhesions,butalsohasadvantagesincludingsmalltrauma,lessbleeding,patientsrecoverfasterandlowercomplicationratecanpreventre~occurren
8、eeofadhesions,itisworthyofpromotionandapplicationinclinic.[Keywords]Laparoscopic;Adhesionlysis;Obstruction;Efficacy粘连性肠梗阻是常见的腹部外科疾病之一,通常由手术、创伤或腹腔内感染引起,其中手术引起约占80%[1]。临床研究表明,传统开腹手术虽能清除粘连,但手术创伤大,并发症较多,随着腹腔镜技术的发展,腹腔镜粘连松解术逐渐被广泛应用于临床,成为H前治疗粘