论文部分内容阅读
目的 探讨预防左半结肠癌梗阻Ⅰ期切除吻合术后吻合口瘘发生的新方法。方法 将1987年1月～1999年1月左半结肠癌梗阻接受术中结肠灌洗和Ⅰ期切除吻合等处理的215例患者分为两组。引流组术中吻合口上下经肛门放置肠腔内双管引流。扩肛组术中不放置肠腔内引流管,术后定时扩肛。对两组病人术后并发症进行对比分析。结果 切口感染、腹腔感染和吻合瘘发生率:引流组分别为4.62％(6/130)、1.54％(2/130)和0;扩肛组分别为5.88％(5/85)、8.24％(7/85)和5.88％(5/85)。两组切口感染发生率无显著性差异(P>0.05),腹腔感染和吻合口瘘发生率有显著性差异(P<0.05)。结论 吻合中上下肠腔内双管引流具有预防性结肠“内造瘘”作用和持续性扩肛作用,能有效地预防左半结肠癌梗阻Ⅰ期切除吻合术后吻合口瘘的发生。
Objective To explore a new method to prevent the occurrence of anastomotic leakage in patients with left-sided colon cancer after primary resection and anastomosis. Methods Two hundred and fifty-five patients who underwent colonic lavage and stage I resection and anastomosis for left colon cancer from January 1987 to January 1999 were divided into two groups. In the drainage group, double anastomosis was performed through the anus through the anastomosis. In the anal group, no drainage tube was placed in the lumen of the intestine, and the anus was regularly expanded after the operation. The postoperative complications of the two groups of patients were compared and analyzed. Results The incidence of incision infection, abdominal infection and anastomosis were 4.62% (6/130), 1.54% (2/130) and 0 in the drainage group, and 5.88% (5/85) and 8.24% in the anal expansion group, respectively. 7/85) and 5.88% (5/85). There was no significant difference in the incidence of incision infection between the two groups (P>0.05), and there was a significant difference in the incidence of intra-abdominal infection and anastomotic leakage (P<0.05). Conclusion Anastomotic double-tube drainage in the upper and lower intestine has a preventive colonic internal sacral effect and continuous anal expansion. It can effectively prevent the occurrence of anastomotic fistula in patients with left-sided colon cancer after primary resection and anastomosis.