肠梗阻是一种常见的术后疾病,可导致住院时间大幅延长。由于肠梗阻被视为手术的正常结果,并不常作为并发症报导,因此其患病率难以估测。并且,文献中的各种定义不一致,使得发生率更难以量化。[4]Wolthuis AM, Bislenghi G, Fieuws S, et al. Incidence of prolonged postoperative ileus after colorectal surgery: a systematic review and meta-analysis. Colorectal Dis. 2016;18:O1-9.http://www.ncbi.nlm.nih.gov/pubmed/26558477?tool=bestpractice.com根据报告,剖腹手术相关的肠梗阻发生率为 9%。据报导,胸腔手术后出现肠梗阻的比率为 1.6% ,而整形外科手术达到 1.4%。[5]Senagore AJ. Pathogenesis and clinical and economic consequences of postoperative ileus. Am J Health Syst Pharm. 2007;64:S3-S7.http://www.ncbi.nlm.nih.gov/pubmed/17909274?tool=bestpractice.com
在美国,肠梗阻每年约增加 7.5-10 亿美元的医疗费用。[5]Senagore AJ. Pathogenesis and clinical and economic consequences of postoperative ileus. Am J Health Syst Pharm. 2007;64:S3-S7.http://www.ncbi.nlm.nih.gov/pubmed/17909274?tool=bestpractice.com[6]Luckey A, Livingston E, Taché Y. Mechanisms and treatment of postoperative ileus. Arch Surg. 2003;138:206-214.http://archsurg.ama-assn.org/cgi/content/full/138/2/206http://www.ncbi.nlm.nih.gov/pubmed/12578422?tool=bestpractice.com美国每年约有 2200 万例住院外科手术,其中约有 270 万患者发生持续 1 天以上的术后肠梗阻。[5]Senagore AJ. Pathogenesis and clinical and economic consequences of postoperative ileus. Am J Health Syst Pharm. 2007;64:S3-S7.http://www.ncbi.nlm.nih.gov/pubmed/17909274?tool=bestpractice.com[7]Story SK, Chamberlain RS. A comprehensive review of evidence-based strategies to prevent and treat postoperative ileus. Dig Surg. 2009;26:265-275.https://www.karger.com/Article/Pdf/227765http://www.ncbi.nlm.nih.gov/pubmed/19590205?tool=bestpractice.com约有 10% 的患者在进行了腹部大手术之后再次住院,其中约有半数是因为迟发性术后肠梗阻再次入院。患者再次住院后需要进行诸如 CT 扫描之类的必要检查,因此该疾病也会增加医疗费用。由于需要进行诊断性检查,术后肠梗阻所增加的费用与其他更严重的术后并发症相当。[8]Doorly MG, Senagore AJ. Pathogenesis and clinical and economic consequences of postoperative ileus. Surg Clin North Am. 2012;92:259-272.http://www.ncbi.nlm.nih.gov/pubmed/22414412?tool=bestpractice.com