腹腔镜下肠粘连松解术治疗粘连性肠梗阻临床体会.docVIP

精品论文 参考文献 腹腔镜下肠粘连松解术治疗粘连性肠梗阻临床体会 霍勇军 王文峰 　　（资阳市雁江区人民医院外科 641300） 　　【摘 要】目的：探讨腹腔镜肠粘连松解术治疗粘连性肠梗阻的方法，提高粘连性肠梗阻的治疗效果。方法：回顾分析1913～2014年我院开展的利用腹腔镜治疗粘连性肠梗阻16例，在腹腔镜下用分离钳、分离剪或超声刀分离粘连，解除梗阻。结果：16例中成功14例，其中2例中转开腹，其中1例因肠管间及肠管与腹壁间广泛粘连而中转开腹，1例因探查未发现明显粘连，横结肠积气扩张而开腹探查，术后诊断为“结肠脾曲综合征”，单纯腹腔镜组无并发症发生，随访3～40个月，均无梗阻复发。结论：选择合适的粘连性肠梗阻病例行腹腔镜粘连松解术是安全、实用的，具有损伤少、出血少、探查范围广、术后恢复快及各并发症少的优点。 　　【关键词】腹腔镜下；肠粘连松解术；治疗；粘连性肠梗阻；体会 　　【中图分类号】R574.2 【文献标识码】B 【文章编号】1003-5028（2015）8-0516-01 　　【Abstract】Objective：to investigate the laparoscopic treatment of intestinal adhesion release of adhesion sex intestinal obstruction methods, to improve the therapeutic effect of adhesion sex intestinal obstruction. Methods：retrospective analysis was carried out in our hospital from 1913 to 2014 in use of laparoscopic treatment of adhesive intestinal obstruction in 16 cases, separation with forceps in laparoscopic separation, separation or ultrasonic knife cut adhesion, remove obstruction. Results：in 14 cases of success, including 2 cases of transfer laparotomy, 1 cases due to the association and extensive adhesion between the intestinal canal and abdominal wall transfer laparotomy, 1 case with probe found no obvious adhesion, transverse colon pneumatosis expansion and laparotomy exploration, postoperative diagnosis of colon splenic flexure syndrome \, pure laparoscopic group without complications, followed up for 3 ~ 40 months, no recurrence of obstruction. Conclusion：to choose the appropriate line adhesion ileus cases of laparoscopic adhesiotomy solution is safe, practical, with less damage, less bleeding, wide detection range, the advantages of rapid recovery and less complications after surgery. 　　【Abstract】laparoscopic; Intestinal adhesion release; Treatment; Adhesion sex intestinal obstruction. Experience 　　粘连性肠梗阻是腹部外科常见疾患之一，分为先天性及后天性两种。后天性因素是粘连性肠梗阻的主要病因，腹腔异物、炎症、创伤、出血等因素的刺激可以产生广泛粘连（以腹部手术、感染性疾病等居多），但70%～80%是腹部手术引起的粘连［1］。粘连性肠梗阻保守治疗效果欠佳，传统的开腹手术再粘连发生率高，手术次数越多，粘连越严重，开腹手术多需做较长的切口，术后伤口疼痛，病人不愿活动，术后肠功能恢复时间长，再次粘连机会增加。我院