腹部手术后粘连造成的影响和负担,视频 播放
粘连是体内疤痕组织形成的一种纤维素带,可以将正常情况下和本不相连的组织或是器官粘在一起。1粘连是腹部手术最常见的并发症,在施行腹部手术的患者中90% 以上均有发生1,2

粘连的风险和负担


粘连患者不得不遭受各种短期及长期手术并发症,进而给患者本人,外科医师,以及整个医疗卫生系统带来负担。这些并发症包括:

  • 小肠梗阻(SBO)3
  • 女性不孕症3
  • 慢性盆腹腔疼痛3
  • 再次粘连松解术(手术移除粘连)3
  • 手术时间延长,而且罹患相关并发症风险增加3
  • 未来的治疗方案受限3
  • 死亡风险增加4,5

尽管在外科手术过程中能够也应该尽最大努力预防粘连形成,但粘连 — 作为组织自然愈合过程的一部分 — 单纯靠手术技巧是不足以防止其发生的。3,6而且并非所有的粘连都是有问题的,其中许多是引发多种伴随疾病的征兆,只是未被确诊。3,4

粘连形成
单个纤维带粘连引发的 SBO,需要再次手术。

PubMed Abstracts


Adhesions and colorectal surgery - call for action

Parker MC, Wilson MS, van Goor H, et al. Colorectal Dis. 2007;9(suppl 2):66-72

Mounting evidence highlights that adhesions are now the most frequent complication of abdominopelvic surgery, yet many surgeons are still not aware of the extent of the problem and its serious consequences. VIEW ABSTRACT »

Practicalities and costs of adhesions

Wilson MS. Colorectal Dis. 2007; 9(suppl 2):60-5

In spite of postoperative adhesions being common there appears to be a reluctance to use anti-adhesion products routinely. This article compares the incidence of adhesions with other conditions in order to identify the level of risk. VIEW ABSTRACT »

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关于本网站


术后粘连认知资料中心专为医疗保健专业人员设计,包括外科医生,护士,医师助理,医院管理和物资采购专业人员和医疗保健政策制定人员等。目的在于提高上述人员对术后粘连形成相关因素,以及患者可能承受严重后果的认识水平。如今的外科学界以及卫生保健规划从业人员,普遍对粘连本身以及它对患者预后产生的不利影响均缺乏正确的认识。这种认知不足也不利于各种预防粘连发生或是减小其损害的工作开展。您可以在本网站找到粘连及其相关并发症的各种有价值的资源,包括同行评议的论文,相关讲座,以及视频资料。请将本页面设为书签并返回更新。


医疗保健专业顾问信息公开:自 2013 年 6 月起,Mike Parker 教授开始有偿参加下列相关产业起步项目:专题研讨会(Applied Medical, Covidien, Ethicon Endo Surgery, Sanofi)和临床研究(Carpo Novum)

References

  1. Sikirica V, Bapat B, Candrill SD, Davis KL, Wilson M, Johns A. The inpatient burden of abdominal and gynecological adhesiolysis in the US. BMC Surg. 2011;11:13.
  2. ten Broek RP, Issa Y, van Santbrink EJ, et al. Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis. BMJ. 2013;347:f5588.
  3. Bruggmann D, Tchartchian G, Wallwiener M, Munstedt K, Tinneberg H-R, Hackethal A. Intra-abdominal adhesions. Dtsch Arztebl Int. 2010;107(44):769-775.
  4. DeWilde RL, Trew G; Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE). Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Gynecol Surg. 2007;4:161-168.
  5. van Goor H. Consequences and complications of peritoneal adhesions. J Assoc of Coloproctology of Great Britain and Ireland. 2007;9(suppl 2):25-34.
  6. DeWilde RL, Trew G; Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE). Postoperative abdominal adhesions and their prevention in gynaecological surgery. Expert consensus position. Part 2—steps to reduce adhesions. Gynecol Surg. 2007;4:243-253.