PDF(Pubmed)
Abstract：
Background Adhesions occur frequently after surgery. A number of methods are being employed for reducing post-operative adhesions. The purpose of this study was to determine the efficacy of hyaluronic acid gel in the reduction of post-operative bowel obstruction symptoms in patients undergoing emergency laparotomy due to small bowel perforation and presenting with peritonitis. Methods In this experimental study, 78 patients were evaluated. All had presented to the emergency department with peritonitis secondary to small bowel perforation. Exploratory laparotomy was performed and after thorough lavage, a loop stoma was formed on the right side of the abdomen with an injection of hyaluronic acid gel injected into the abdominal cavity before the closure of the abdomen. Postoperative obstructive symptoms at one, three, and six months were evaluated. All patients underwent stoma reversal at three months. Results Obstructive bowel symptoms were seen in 18 patients (23.07%) patients. The cumulative incidence of obstructive symptoms at three months was only 8.97% but after the second intervention without protective gel, it increased to 23.07% at six months. Conclusions Cross-linked hyaluronic acid gel was effective in the reduction of post-operative bowel obstructive symptoms due to adhesions in patients who had presented with peritonitis due to small bowel perforation and had undergone exploratory laparotomy with stoma formation.
摘要：
背景技术术后粘连常发生。许多方法被用于减少术后粘连。这项研究的目的是确定透明质酸凝胶在减少由于小肠穿孔和腹膜炎而进行紧急剖腹手术的患者术后肠梗阻症状中的功效。方法本实验研究,对78例患者进行了评估。所有患者均因小肠穿孔继发腹膜炎而被送往急诊科。进行剖腹探查术，彻底灌洗后，在腹部闭合前，向腹腔注射透明质酸凝胶，在腹部右侧形成环形造口。术后梗阻症状，三,并对六个月进行了评估。所有患者在三个月时进行造口逆转。结果18例(23.07%)患者出现肠梗阻症状。3个月时阻塞性症状的累积发生率仅为8.97%，但在没有保护凝胶的第二次干预后，六个月后上升至23.07%。结论交联透明质酸凝胶可有效减轻因小肠穿孔引起的腹膜炎和剖腹探查造口形成的患者术后因粘连引起的肠梗阻症状。
