论文部分内容阅读
目的 探讨引流管的放置对腹腔镜胃癌根治术术后康复的影响.方法 选取河南中医药大学第一附属医院2014年9月—2017年6月行腹腔镜胃癌D2根治术的患者179例, 并根据引流管的放置位置和根数, 随机分为3组, 肝下引流管放置组 (A组, n=66);吻合口引流管放置组 (B组=57);肝下和吻合口引流管放置组 (C组, n=56) .使用相同的围手术期处理方法, 比较术后3 d引流量, 术后恢复情况及术后3个月并发症情况.结果 A, B, C三组术后排气时间分别为 (64.2±28.2) h, (66.4±27.0) h, (64.7±30.8) h, 差异无统计学意义 (F=0.097, P＞0.05);三组术后排便时间分别为 (77.8±30.0) h, (84.7±27.4) h, (82.3±33.7) h, 差异无统计学意义 (F=0.831, P＞0.05);三组术后胃管拔除时间分别为 (6.3±1.7) d, (6.1±1.7) d, (6.1±1.6) d, 差异无统计学意义 (F=0.177, P＞0.05);三组术后住院时间分别为 (11.0±1.3) d, (11.5±1.9) d, (10.7±1.7) d, 差异具有统计学意义 (F=3.555, P＜0.05);三组术后3 d平均引流量分别为 (329.7±40.0) ml, (324.8±40.4) ml, (349.4±42.4) ml, 差异具有统计学意义 (F=5.841, P＜0.05) .A, B, C三组术后并发症例数分别为26、21、22例, 差异无统计学意义 (χ2=0.103, P＞0.05);腹腔出血例数分别为1、0、2例, 差异无统计学意义 (χ2=2.203, P＞0.05);切口问题例数分别为2、1、0例, 差异无统计学意义 (χ22=1.691, P＞0.05);吻合口瘘例数分别为1、0、2例, 差异无统计学意义 (χ2=2.203, P＞0.05);肠梗阻例数分别为1、1、0例, 差异无统计学意义 (χ2=0.937, P＞0.05);DVT例数分别为21、19、18例, 差异无统计学意义 (χ2=.035, P＞0.05);A, B, C三组术后均未出现死亡病例, 差异无统计学意义.结论 肝下引流管放置对腹腔镜胃癌D2根治术患者短期预后效果最佳.“,”Objective To investigate the effect of drainage tube placement on the rehabilitation of laparoscopic radical gastrectomy for gastric cancer. Methods In our hospital from September 2014 June-2017 underwent laparoscopic radical resection of gastric cancer patients with D2 179 cases, and according to the drainage tube placement and root number, were randomly divided into 3 groups, placing drainage tube under the liver group (group A, n = 66); anastomotic drainage group (B group = 57); liver and anastomotic drainage group (group C, n = 56). The same perioperative treatment method was used to compare the flow rate of 3 days after operation, postoperative recovery and complications after operation in March. Results A, B, C three groups of postoperative exhaust time were (64. 2 ± 28. 2) h, (66. 4 ±27. 0) h, (64. 7 ± 30. 8) h, the difference was not statistically significant (F = 0. 097, P＞ 0. 05); defecation time after operation in three groups were (77. 8 ± 30. 0) h, (84. 7 ± 27. 4) h, (82. 3 ± 33. 7) h, the difference was not statistically significant (F = 0. 831, P＞ 0. 05); gastric extubation time after operation in three groups were (6. 3 ± 1. 7) d, (6. 1 ±1. 7) d, (6. 1 ± 1. 6) d, the difference was not statistically significant (F = 0. 177, P＞ 0. 05); three groups of postoperative hospitalization time was (11 ± 1. 3) d, (11. 5 ± 1. 9) d, (10. 7 ± 1. 7) d, the difference was statistically significant (F = 3. 555, P＜ 0. 05); the three group after 3 days average drainage volume were (329. 7 ± 40. 0) ml, (324. 8 ±40. 4) ml, (349. 4 ± 42. 4) ml, the difference was statistically significant (F = 5. 841, P＜ 0. 05). A, B, C three groups of postoperative complications were 26, 21, 22, the difference was not statistically significant (χ2= 0. 103, P＞0. 05); intra-abdominal hemorrhage cases were 1, 0, 2, the difference was not statistically significant (χ2= 2. 203, P＞ 0. 05); the number of cases of incision problems were 2. 1, 0, no significant difference (χ2= 1. 691, P＞ 0. 05);anastomotic fistula cases were 1, 0, 2, the difference was not statistically significant (χ2= 2. 203, P＞ 0. 05); the number of cases of intestinal obstruction were 1, 1, 0, the difference was not statistically significant (χ2= 0. 937, P＞0. 05); DVT cases were 21, 19, 18, the difference was statistically significant (χ2= 0. 035, P＞ 0. 05); A, B, C after operation in the three groups were no deaths, no statistically significant difference. Conclusion The placement of the sub hepatic drainage tube has the best short-term prognosis for patients with laparoscopic D2 radical gastrectomy.