尹克宁　韩建军

【摘要】 目的：探讨腹腔镜治疗粘连性肠梗阻的临床价值。方法：选取本院2010年2月-2015年2月期间收治的粘连性肠梗阻患者100例，按照治疗方法的不同将其分为腹腔镜组和开腹组，每组50例。其中腹腔镜组患者采用腹腔镜肠粘连松解术进行治疗，开腹组患者则行常规开腹肠粘连松解术，对两组患者的临床治疗效果进行评估记录，并对患者的手术时间、术中出血量、术后肠蠕动恢复时间、住院时间、术后切口感染及镇痛药物使用情况进行对比分析。结果：开腹组患者均顺利完成开腹肠粘连松解术，腹腔镜组50例患者中，1例患者因肠间粘连成团，转行开腹肠切除吻合术。腹腔镜组患者的手术时间、术后肠蠕动恢复时间及住院时间均明显短于对照组，术中出血量明显少于对照组，术后切口感染发生率、镇痛药物使用率均明显低于对照组，差异均有统计学意义（P<0.05）。结论：采用腹腔镜治疗粘连性肠梗阻，安全有效，能够有效减少手术创伤，有利于促进患者术后尽早康复，且其适用范围广，是一种可靠的治疗粘连性肠梗阻的措施。

【关键词】 粘连性肠梗阻； 腹腔镜； 治疗价值

【Abstract】 Objective：To investigate the clinical value of laparoscopic in the treatment of adhesive intestinal obstruction.Method：100 patients with adhesive intestinal obstruction admitted to our hospital from February 2010 to February 2015 were randomly divided into the laparoscope group and the laparotomy group according to the different treatment methods，50 cases in each group.The patients in the laparoscope group were treated with accretion-lysis under laparoscope.Patients in the laparotomy group were treated with conventional enterolysis through laparotomy.The clinical therapeutic effects of the two groups were evaluated and recorded，and the operative time，intraoperative blood loss volume，postoperative intestinal peristalsis recovery time，the length of stay，postoperative incision infection and the use of analgesic drugs between the two groups were compared and analyzed.Result：Open intestinal adhesion lysis was successfully performed in the laparotomy group.In the 50 cases of laparoscope group，1 patient was converted to open anastomosis of intestinal resection because of intestinal adhesion.The operative time，postoperative intestinal peristalsis recovery time and the length of stay in the laparoscope group were significantly shorter than those in the laparotomy group，the intraoperative blood loss volume of the laparoscope group was significantly less than the laparotomy group，the rates of postoperative incision infection and analgesic drugs use in the laparoscope group were significantly lower than those in the laparotomy group，the differences were statistically significant（P<0.05）.Conclusion：The laparoscopic in the treatment of adhesive intestinal obstruction is safe and effective，it can decrease the operative trauma effectively，also，it is conducive to promoting the recovery of the patient as soon as possible，with wide range of application，therefore，it is a reliable treatment regimen for adhesive intestinal obstruction.

【Key words】 Adhesive intestinal obstruction； Laparoscopy； Therapeutic value

First-authors address：The Central Hospital of Shangqiu City，Shangqiu 476000，China

doi：10.3969/j.issn.1674-4985.2016.05.014

粘连性肠梗阻是一种腹部外科常见疾病类型，临床调查指出，90%的患者在腹部外科手术后会出现不同程度的肠黏连，其中40%左右则会出现粘连性肠梗阻[1-2]。近年来有报道指出，保守治疗虽然不会引起手术创伤，但是对粘连性肠梗阻的治疗效果有限，因此目前临床普遍认为对于此类患者建议优先考虑手术方案。随着近年来腹腔镜技术的不断发展，其适应证和手术范围得到扩大，在肠黏连的治疗中得到广泛应用[3]。本次研究为探讨采用腹腔镜治疗粘连性肠梗阻的临床效果，随机选取本院近年来收治的粘连性肠梗阻患者100例，分别对其进行腹腔镜治疗和开腹手术治疗，现将结果汇报如下。……