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目的:研究一种彻底快速而毫不污染手术野的术中肠减压方法,以便提高手术的安全性。方法:游离系膜后,钳夹下将拟切除肠段的下端先切断,将其近侧断端置入并固定于粘附在手术床边的塑料袋中;松开肠钳,肠内容物自由流入袋内;双手交替推挤膨胀的肠段,由近而远,由小肠向大肠,直至大、小肠的内容物彻底排空。钳夹下切断上端,移除切下的肠段和充满粪便的塑料袋。结果:使用本法行肠减压术,一期切除急性梗阻的左结肠癌31例,均未发生吻合口漏,创口一期愈合。另有6例肝段切除同时切除未作肠道准备的结肠癌,亦取得同样结果。同法亦用于各种急性小肠梗阻,均未造成腹腔污染。结论:本法可推荐为术中肠减压的首选方法。
OBJECTIVE: To study a method of decompression of the intestine that is completely rapid and does not contaminate the surgical field, so as to improve the safety of the operation. METHODS: After the mesangial was dissociated, the lower end of the intestine to be resected was cut off under the clamp and the proximal end was inserted and fixed in a plastic bag attached to the side of the operating bed; the intestinal clamp was loosened and the intestinal contents were released. Free flow into the bag; hands alternately push the swollen segment of the bowel, from near to far, from the small intestine to the large intestine, until the contents of the large and small intestines are completely empty. Cut off the upper end under the clamp and remove the cut bowel section and plastic bag filled with feces. Results: The bowel decompression was performed using this method. In the first stage, 31 cases of left colon cancer with acute obstruction were resected. No anastomotic leakage occurred, and the wound healed in one stage. Another group of 6 patients who underwent resection of the liver at the same time did not undergo intestinal preparation for colon cancer and achieved similar results. The same method was also used for various acute small bowel obstructions, and did not cause abdominal contamination. Conclusion: This method can be recommended as the preferred method for intraoperative decompression.