Menzies D, Ellis H
Westminster Hospital.
Ann R Coll Surg Engl. 1990 Jan;72(1):60-3.
Apart from one post-mortem study, the incidence of adhesions following laparotomy has not been well documented. 1. In a prospective analysis of 210 patients undergoing a laparotomy, who had previously had one or more abdominal operations, we found that 93% had intra-abdominal adhesions that were a result of their previous surgery. This compared with 115 first-time laparotomies in which 10.4% had adhesions. 2. Over a 25-year period, 261 of 28 297 adult general surgical admissions were for intestinal obstruction from adhesions (0.9%). Of 4502 laparotomies, 148 were for adhesive obstruction (3.3%). 3. Over a 13-year period all laparotomies were followed up for an average of 14.5 months (range 0-91 months). From these 2708 laparotomies, 26 developed intestinal obstruction due to postoperative adhesions within 1 year of surgery (1%). Fourteen did so within 1 month of surgery (0.5%). 4. The majority of the operations producing intestinal obstruction were lower abdominal, principally involving the colon. The volume of general surgical work from adhesions is large and the incidence of early intestinal obstruction is high.
除了一项尸检研究外，剖腹手术后粘连的发生率尚无充分记录。1. 在对210例曾接受过一次或多次腹部手术的剖腹手术患者进行的前瞻性分析中，我们发现93%的患者有腹腔内粘连，这是其先前手术的结果。相比之下，在115例初次剖腹手术患者中，有粘连的比例为10.4%。2. 在25年期间，28297例成人普通外科住院患者中有261例（0.9%）因粘连导致肠梗阻。在4502例剖腹手术中，148例（3.3%）是因粘连性梗阻。3. 在13年期间，对所有剖腹手术患者平均随访了14.5个月（范围为0至91个月）。在这2708例剖腹手术中，26例（1%）在术后1年内因术后粘连发生肠梗阻。其中14例（0.5%）在术后1个月内发生。4. 导致肠梗阻的手术大多数发生在下腹部，主要涉及结肠。因粘连导致的普通外科工作量很大，早期肠梗阻的发生率很高。
