目的：对比观察聚乳酸防粘连凝胶和透明质酸钠在预防腹部手术后肠粘连的效果，以指导临床用药。方法根据患者选择抗粘连药物的不同，将患者分为聚乳酸防粘连凝胶组（427例）和透明质酸钠组（429例），于手术结束关腹前，分别涂以聚乳酸防粘连凝胶或透明质酸钠，观察患者术后体温恢复正常所需时间、肠管通气时间以及术后6个月内肠粘连的表现。结果所有患者中，术后均无药物过敏现象出现，无脓肿、肠瘘及其他不良反应发生，术后改善情况良好。观察术后1周患者发热时间、肠鸣音恢复时间、肛门排气时间，聚乳酸防粘连凝胶组均短于透明质酸钠组（ P＜0.01）。聚乳酸防粘连凝胶组在术后3个月和术后6个月发生肠粘连表现的例数也少于透明质酸钠组（ P＜0.05）。结论聚乳酸防粘连凝胶和透明质酸钠对腹部手术后预防肠粘连均有明显作用，聚乳酸防粘连凝胶预防粘连效果优于透明质酸钠。%Objective To compare the effects of polylactic acid anti-adhesion gel and sodium hyaluronate in the prevention of postoperative intestinal adhesion , to guide the clinical use of drugs .Methods According to the se-lected anti adhesion drug , the patients were divided into polylactic acid anti-adhesion gel group and sodium hyalur-onate group , and were coated with polylactic acid anti-adhesion gel or sodium hyaluronate on the surgical wound at the end of operation and before closing abdomen .After operation , the time of temperature returning to normal , intestine ventilation time and the intestinal adhesion performance at 6 months after operation were observed .Results In all pa-tients, postoperative improvement was in good condition and no drug allergies , abscess, fistula and other adverse re-actions were found.Observation of postoperative 1 week showed patients′heating time, borborygmus recovery time, anal exhaust time , in polylactic acid anti-adhesion gel group were significantly better than those of sodium hyaluronate group(P<0.01).At 3 months or at 6 months after operation, the number of patients with intestinal adhesion per-formance in polylactic acid anti-adhesion gel group was significantly less than that in the sodium hyaluronate group ( P<0.05 ) .Conclusion Polylactic acid anti-adhesion gel and sodium hyaluronate in preventing postoperative intestinal adhesions have obvious effects , but the prevention effect of polylactic acid anti-adhesion gel is better than that of sodi-um hyaluronate .
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