Gudiev Chersi, Minaev Sergey, Vasiliev Viktor
Department of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia.
Department of Pediatric Surgery, Stavropol State Medical University of the Ministry of Health of the Russian Federation, Stavropol, Russia.
North Clin Istanb. 2023 Feb 13;10(1):33-39. doi: 10.14744/nci.2022.21347. eCollection 2023.
The purpose of the research was to assess the performance of the method of prevention of post-operative peritoneal adhesions (PAs) (author's method) in patients of different age groups.
Two hundred eighty-five patients were in total enrolled in the study. The patients of two age groups were divided into two groups: Group 1 (treatment group), where the author's method was used on 143 patients, and Group 2 (control group) 142 patients, where was used the standard approach of prevention of intra-abdominal adhesions. All patients were operated in an urgent order on adhesive intestinal obstruction (AIO). The patients previously had surgery on AIO one to 3 times. Within each group, sick children and adults were identified. The gender distribution was comparable in both groups.
The recurrence of AIO was significantly less in Group 1 than in Group 2 (1.4% and 6.3%, respectively, p<0.05). A separate study of the results of treatment in the age aspect in groups showed some features. Among children the AIO relapse rate in study Groups 1 and 2: Early AIO-in 1 (0.86%) and 2 (1.8%) patients, respectively; late AIO-in 1 (0.86%) and 4 (3.5%), patients, respectively. Among adults who didn't have relapse AIO during the follow-up period in Group 1. The AIO relapse rate in Group 2: Early AIO - in 1 (3.5%) and late AIO-2 (6.9%) patients, respectively.
The proposed author's method for preventing AIO recurrence has shown its effectiveness among patients with adhesive AIO. Besides, using this method in children to reduce the AIO relapse rate by more than thrice; in adult patients, to prevent the development of clinically significant signs of PA and normalize the patient's quality of life.
本研究旨在评估预防术后腹膜粘连（PA）的方法（作者的方法）在不同年龄组患者中的效果。
本研究共纳入285例患者。两个年龄组的患者被分为两组：第1组（治疗组），对143例患者采用作者的方法；第2组（对照组），142例患者采用预防腹腔内粘连的标准方法。所有患者均因粘连性肠梗阻（AIO）接受急诊手术。这些患者此前因AIO接受过1至3次手术。在每组中，分别确定了患病儿童和成人。两组的性别分布具有可比性。
第1组AIO的复发率明显低于第2组（分别为1.4%和6.3%，p<0.05）。对两组按年龄进行的治疗结果单独研究显示出一些特点。在儿童中，第1组和第2组的AIO复发率：早期AIO分别为1例（0.86%）和2例（1.8%）；晚期AIO分别为1例（0.86%）和4例（3.5%）。在第1组随访期间未出现AIO复发的成人中。第2组的AIO复发率：早期AIO分别为1例（3.5%）和晚期AIO为2例（6.9%）。
作者提出的预防AIO复发的方法在粘连性AIO患者中显示出了有效性。此外，在儿童中使用该方法可将AIO复发率降低三倍以上；在成年患者中，可预防PA出现具有临床意义的体征，并使患者的生活质量恢复正常。
