目的:分析粘连性肠梗阻患者应用常规开腹手术、腹腔镜肠粘连松解术治疗的临床病理学特性及预后效果。方法:收集2020年6月至2022年6月期间于青岛大学附属医院急诊普外科接受手术治疗的154例粘连性肠梗阻患者的临床资料,分为腔镜组和开腹...目的:分析粘连性肠梗阻患者应用常规开腹手术、腹腔镜肠粘连松解术治疗的临床病理学特性及预后效果。方法:收集2020年6月至2022年6月期间于青岛大学附属医院急诊普外科接受手术治疗的154例粘连性肠梗阻患者的临床资料,分为腔镜组和开腹组,各77例。比较两组手术相关指标、并发症,并观察手术前后血清指标。结果:腔镜组与开腹组手术疗效差异无统计学意义(P > 0.05);腔镜组切口直径、手术操作耗时、围术期失血量、术后初次离床时间、术后初次排气时间、总住院天数、视觉模拟法(visual analog scale, VAS)评分、并发症发生率均低于开腹组,差异具有统计学意义(P P Objective: To analyze the clinical pathology characteristics and prognosis of patients with adhesive intestinal obstruction treated with conventional open surgery and laparoscopic intestinal lysis. Methods: From June 2020 to June 2022, 154 consecutive patients with adhesive intestinal obstruction, who were treated in the Emergency General Surgery Department of the Affiliated Hospital of Qingdao University, were divided into two groups: laparoscopic group and Open Group, 77 cases each. The related indexes, complications and serum indexes before and after operation were compared between the two groups. Results: There was no significant difference in surgical efficacy between the laparoscopic group and the open group (P > 0.05). The incision diameter, operation time, intraoperative blood loss, time to first ambulation after surgery, time to first flatus after surgery, total hospital stay, visual analog scale (VAS) score, and complication incidence rate were all lower in the laparoscopic group than in the open group (P P < 0.05). Conclusion: laparoscopic lysis of intestinal adhesion has the advantages of less incision, less inflammatory reaction, shorter time-consuming, less blood loss, fewer complications, less pain and rapid recovery.展开更多
Gallstone ileus is an uncommon but life-threatening form of mechanical small bowel obstruction,[1]especially in elderly female patients.[2]It is caused by large gallstone impaction that enters the bowel via a cholecys...Gallstone ileus is an uncommon but life-threatening form of mechanical small bowel obstruction,[1]especially in elderly female patients.[2]It is caused by large gallstone impaction that enters the bowel via a cholecystoduodenal fistula.Since the rarity of gallstone ileus is associated with relatively high rates of morbidity and mortality in elderly patients with multiple comorbidities,making an early and accurate diagnosis in emergency settings crucial.展开更多
目的:探讨粘连性小肠梗阻发生术后早期小肠梗阻(Early postoperative small bowel obstruction, EPSBO)的危险因素。方法:回顾性分析2023年1月至2024年12月期间在青岛大学附属医院接受粘连性小肠梗阻手术治疗的256例患者的临床数据。根...目的:探讨粘连性小肠梗阻发生术后早期小肠梗阻(Early postoperative small bowel obstruction, EPSBO)的危险因素。方法:回顾性分析2023年1月至2024年12月期间在青岛大学附属医院接受粘连性小肠梗阻手术治疗的256例患者的临床数据。根据是否发生术后早期小肠梗阻,将患者分为两组:EPSBO组和非EPSBO组。通过单因素和多因素Logistic回归分析,分析粘连性小肠梗阻术后早期小肠梗阻危险因素。结果:共纳入256例患者,EPSBO的发生率为12.50% (32/256)。在单因素分析中,术前低血清白蛋白水平(P Purpose: This study aims to determine risk factors for early postoperative small bowel obstruction (EPSBO) following adhesive small bowel obstruction. Methods: A retrospective analysis was conducted on the clinical data of 256 patients who underwent surgical treatment for adhesive small bowel obstruction (ASBO) at Qingdao University Affiliated Hospital between January 2023 and December 2024. The patients were divided into two groups based on the occurrence of early postoperative small bowel obstruction (EPSBO): the EPSBO group and the non-EPSBO group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for early postoperative small bowel obstruction following adhesive small bowel obstruction surgery. Results: A total of 256 patients were included in the study, with an incidence of early postoperative small bowel obstruction (EPSBO) of 12.50% (32/256). Univariate analysis revealed that preoperative low serum albumin levels (P < 0.001), prolonged surgery duration (P = 0.020), ascites (P = 0.007), and bowel wall edema (P = 0.030) were statistically significant factors associated with the occurrence of EPSBO. Multivariate logistic regression analysis, incorporating these clinical factors, showed that preoperative low albumin levels (OR = 0.91, 95% CI: 0.86~0.97), bowel wall edema (OR = 2.71, 95% CI: 1.09~6.78), and ascites (OR = 2.83, 95% CI: 1.26~6.36) were independent risk factors for the development of early postoperative small bowel obstruction. Conclusion: Preoperative low albumin levels, bowel wall edema, and ascites are important indicators for the early prediction of the occurrence of early postoperative small bowel obstruction following adhesive small bowel obstruction surgery.展开更多
文摘目的:分析粘连性肠梗阻患者应用常规开腹手术、腹腔镜肠粘连松解术治疗的临床病理学特性及预后效果。方法:收集2020年6月至2022年6月期间于青岛大学附属医院急诊普外科接受手术治疗的154例粘连性肠梗阻患者的临床资料,分为腔镜组和开腹组,各77例。比较两组手术相关指标、并发症,并观察手术前后血清指标。结果:腔镜组与开腹组手术疗效差异无统计学意义(P > 0.05);腔镜组切口直径、手术操作耗时、围术期失血量、术后初次离床时间、术后初次排气时间、总住院天数、视觉模拟法(visual analog scale, VAS)评分、并发症发生率均低于开腹组,差异具有统计学意义(P P Objective: To analyze the clinical pathology characteristics and prognosis of patients with adhesive intestinal obstruction treated with conventional open surgery and laparoscopic intestinal lysis. Methods: From June 2020 to June 2022, 154 consecutive patients with adhesive intestinal obstruction, who were treated in the Emergency General Surgery Department of the Affiliated Hospital of Qingdao University, were divided into two groups: laparoscopic group and Open Group, 77 cases each. The related indexes, complications and serum indexes before and after operation were compared between the two groups. Results: There was no significant difference in surgical efficacy between the laparoscopic group and the open group (P > 0.05). The incision diameter, operation time, intraoperative blood loss, time to first ambulation after surgery, time to first flatus after surgery, total hospital stay, visual analog scale (VAS) score, and complication incidence rate were all lower in the laparoscopic group than in the open group (P P < 0.05). Conclusion: laparoscopic lysis of intestinal adhesion has the advantages of less incision, less inflammatory reaction, shorter time-consuming, less blood loss, fewer complications, less pain and rapid recovery.
基金National Natural Science Foundation of China(81902379)Chenguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission(21CGA20)Cultivation Foundation of Renji Hospital(RJPY-LX-011).
文摘Gallstone ileus is an uncommon but life-threatening form of mechanical small bowel obstruction,[1]especially in elderly female patients.[2]It is caused by large gallstone impaction that enters the bowel via a cholecystoduodenal fistula.Since the rarity of gallstone ileus is associated with relatively high rates of morbidity and mortality in elderly patients with multiple comorbidities,making an early and accurate diagnosis in emergency settings crucial.
文摘目的:探讨粘连性小肠梗阻发生术后早期小肠梗阻(Early postoperative small bowel obstruction, EPSBO)的危险因素。方法:回顾性分析2023年1月至2024年12月期间在青岛大学附属医院接受粘连性小肠梗阻手术治疗的256例患者的临床数据。根据是否发生术后早期小肠梗阻,将患者分为两组:EPSBO组和非EPSBO组。通过单因素和多因素Logistic回归分析,分析粘连性小肠梗阻术后早期小肠梗阻危险因素。结果:共纳入256例患者,EPSBO的发生率为12.50% (32/256)。在单因素分析中,术前低血清白蛋白水平(P Purpose: This study aims to determine risk factors for early postoperative small bowel obstruction (EPSBO) following adhesive small bowel obstruction. Methods: A retrospective analysis was conducted on the clinical data of 256 patients who underwent surgical treatment for adhesive small bowel obstruction (ASBO) at Qingdao University Affiliated Hospital between January 2023 and December 2024. The patients were divided into two groups based on the occurrence of early postoperative small bowel obstruction (EPSBO): the EPSBO group and the non-EPSBO group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for early postoperative small bowel obstruction following adhesive small bowel obstruction surgery. Results: A total of 256 patients were included in the study, with an incidence of early postoperative small bowel obstruction (EPSBO) of 12.50% (32/256). Univariate analysis revealed that preoperative low serum albumin levels (P < 0.001), prolonged surgery duration (P = 0.020), ascites (P = 0.007), and bowel wall edema (P = 0.030) were statistically significant factors associated with the occurrence of EPSBO. Multivariate logistic regression analysis, incorporating these clinical factors, showed that preoperative low albumin levels (OR = 0.91, 95% CI: 0.86~0.97), bowel wall edema (OR = 2.71, 95% CI: 1.09~6.78), and ascites (OR = 2.83, 95% CI: 1.26~6.36) were independent risk factors for the development of early postoperative small bowel obstruction. Conclusion: Preoperative low albumin levels, bowel wall edema, and ascites are important indicators for the early prediction of the occurrence of early postoperative small bowel obstruction following adhesive small bowel obstruction surgery.
