Analysis Of Surgical Timing For Acute Adhesive Intestinal Obstruction

OBJECTIVE: To explore the choice of surgical timing for acute adhesive intestinal obstruction.METHODS:A retrospective analysis of 180 cases of acute adhesive intestinal obstruction with history of abdominal surgery from August 2012 to February 2017 in the Gastrointestinal surgery Department of affiliated Hospital of Guilin Medical College.According to the relevant treatment methods,There were 84 cases in conservative treatment group and 96 cases in surgical treatment group.According to the clinical data of the patients,univariate analysis and multivariate Logistics linear regression analysis were carried out to analyze the factors affecting the operative opportunity of acute adhesive intestinal obstruction.Finally,the highest risk factors of intestinal dilatation,celiac effusion and definite obstruction were compared.RESULTS:Univariate analysis showed that the number of intestinal adhesions,the time of conservative treatment,whether the abdominal pain continued,the extent of intestinal dilatation,whether the sound of bowel sounds decreased,The amount of peritoneal effusion,white blood cell count were increased or not and Ct indicates obstruction site were selected through single faetor analysis.which were statistically significant(P < 0.05).By Logistic regression analysis,These are independent factors for the timing of surgery(P < 0.05).A comparison of three factors with high risk levels shows that more patients treated with surgery within 7 days When the effusion of the abdominal cavity is greater than 7cm,the dilatation of the intestine is greater than 3.7cm,and the Ct indicates obstruction site.Conclusion:For the patients with acute adhesive intestinal obstruction,the number of intestinal adhesions,the time of conservative treatment,the duration of abdominal pain,the degree of intestinal dilatation,the decrease of bowel sound,The amount of peritoneal effusion,Whether the white blood cell count is increased or not and CT indicates that obstruction site affect the timing of surgery.The amount of peritoneal effusion,the degree of intestinal dilatation and CT indicates obstruction site are closely related to timing of surgery.Especially when the presence of celiac effusion greater than 7 cm,intestinal dilatation greater than 3.7 cm or CT indicates obstruction site,we should be treated as early as possible.