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[慢性腹痛:视频腹腔镜粘连松解术的作用]

[Chronic abdominal pain: role of video-laparoscopic adhesiolysis].

作者信息

Schietroma M, Risetti A, Carlei F, Santirocco M V, Muzi F, Maggi G, De Santis C, Recchia C L, Iannucci D, Rampa R, Simi M

机构信息

Cattedra di Chirurgia Generale, Università degli Studi, L'Aquila.

出版信息

Chir Ital. 1996;48(4):43-6.

PMID:9522099
Abstract

Adhesions have been suggested as a possible cause of chronic abdominal pain, but the reports of their etiological role conflict. Lysis of adhesions has been proposed as the therapeutic modality of choice, although the reports of success are controversial. The aim our prospective study was to determine whether laparoscopic adhesiolysis ameliorates chronic abdominal pain in patients with abdominal adhesions. Forty-one patients with chronic abdominal pain lasting for more than 6 months, but with no abnormal findings other than adhesions found at laparoscopy, underwent laparoscopic adhesiolysis. 37 patients (90.2%) were available for follow-up after a median time interval of 18 months (range: 12-41 months). Twenty-two patients (59.4%) were free from abdominal pain and 9 (24.3%) patients reported significant amelioration of their pain. Six (16.2%) patients had no amelioration. In conclusion the laparoscopy is an effective tool for the evaluation of patients with chronic abdominal pain, and laparoscopic adhesiolysis cures of ameliorates chronic abdominal pain in more than 80% of patients.

摘要

粘连被认为可能是慢性腹痛的一个原因,但关于其病因学作用的报道相互矛盾。尽管粘连松解术成功的报道存在争议,但它已被提议作为首选的治疗方式。我们前瞻性研究的目的是确定腹腔镜粘连松解术是否能改善腹部粘连患者的慢性腹痛。41例慢性腹痛持续超过6个月的患者,除腹腔镜检查发现粘连外无其他异常发现,接受了腹腔镜粘连松解术。37例患者(90.2%)在中位时间间隔18个月(范围:12 - 41个月)后可进行随访。22例患者(59.4%)腹痛消失,9例患者(24.3%)报告疼痛明显改善。6例患者(16.2%)症状未改善。总之,腹腔镜检查是评估慢性腹痛患者的有效工具,腹腔镜粘连松解术能治愈或改善超过80%患者的慢性腹痛。

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