PDF(Pubmed)
Abstract：
Abdominal adhesion occurs commonly in clinical practice, causing unfavorable symptoms and readmission. The ileostomy operation is a common surgical procedure and we utilized this model to evaluate abdominal adhesion. Adhesion grade score was calculated in 35 patients (Cohort 1) and subjected to correlation and receiver operating characteristic analysis. Then 98 consecutive patients (Cohort 2) who underwent ileostomy and ileostomy closure were included into a retrospective study. Logistic regression analysis was performed, and the risk of small bowel obstruction was also assessed. The time of ileostomy closure correlated with adhesion grade score in Cohort 1, justifying its use as an indicator of abdominal adhesion. All patients in Cohort 2 were then divided into the high- and low-adhesion group. A multi-variable logistic regression analysis indicated that type of surgery and peritoneum suture during ileostomy were significant factors affecting the risk of abdominal adhesion. Abdominal adhesion had the trend to prolong the length of stay postoperatively without increasing the risk of bowel obstruction. Nine patients suffered bowel obstruction, and age older than 65 significantly increased the risk. We proposed the ileostomy procedure to be a model of abdominal adhesion, and the operative time of ileostomy closure could be used as an alternative of adhesion score. Type of surgery and peritoneum suture may be risk factors of abdominal adhesion. Older age increased the risk of small bowel obstruction after ileostomy surgery.
摘要：
腹部粘连在临床实践中很常见，导致不利的症状和再入院。回肠造口术是一种常见的外科手术，我们利用该模型来评估腹部粘连。计算了35例患者（队列1）的粘附等级评分，并进行了相关性和接受者操作特征分析。然后，将98例接受回肠造口术和回肠造口术闭合的连续患者（队列2）纳入回顾性研究。进行Logistic回归分析，还评估了小肠梗阻的风险.回肠造口术闭合时间与队列1中的粘连等级评分相关，证明了其作为腹部粘连指标的用途。然后将队列2中的所有患者分为高粘连组和低粘连组。多变量logistic回归分析显示，手术类型和回肠造口术中腹膜缝合是影响腹腔粘连风险的重要因素。腹部粘连有延长术后住院时间的趋势，而不会增加肠梗阻的风险。九名患者患有肠梗阻，而年龄大于65岁则显著增加了风险。我们提出回肠造口术是腹部粘连的模型，回肠造口闭合的手术时间可以作为粘连评分的替代方法。手术类型和腹膜缝合可能是腹腔粘连的危险因素。年龄较大增加回肠造口术后小肠梗阻的风险。
