直肠上动脉插管注射美蓝染色在直肠癌根治术中的应用  

Application of methylthioninium chloride injection into superior rectal artery in radical operation of rectal cancer

作　　者：顾劲松[1] 于海滨[1] 赵明友[1] 

机构地区：[1]鞍山市鞍钢曙光医院外科,辽宁鞍山114033

出　　处：《局解手术学杂志》2006年第2期78-79,共2页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨直肠上动脉插管注射美蓝对直肠癌根治术中全直肠系膜切除(TME)的指示作用及染色后清除淋巴结数量的变化。方法将我科2002年1月至2003年12月行直肠癌手术的病人58例随机分为两组,其中经直肠上动脉插管注射美蓝组28例,普通根治组30例,观察两组淋巴结清除情况。结果注射美蓝组患者直肠系膜染色良好,骶前间隙界限清楚,无输尿管损伤及骶前静脉丛损伤,淋巴结检出数明显高于对照组。结论直肠癌术中经直肠上动脉插管注射美蓝能清楚显示直肠系膜,避免输尿管和骶前静脉丛的损伤,同时能提高系膜淋巴结检出数,便于病理分期。Objective To discuss the indicating effects of methyhhioninium chloride injected into superior rectal arteries in radical rectal excision and the difference in numbers of eliminated lymph nodes between the patients with and without methyhhioninium chloride staining during operation. Methods Totally 28 cases were randomly selected from 58 patients suffered from rectal cancers between January 2002 to December 2003, in whom 6 ml methylthioninium chloride was injected into superior rectal arteries during radical operations, while the rest 30 eases underwent routine radical operations without staining. The staining effect of the mesorectums, lymph nodes and the eliminated lymph nodes were observed. Results In the staining group, the staining of mesorectums and lymph nodes was well enough and the presacral space was clear. No presaeral venous or plexus ureteral injury occurred in 28 cases applying methyhhioninium chloride staining. The number of eliminated lymph nodes （512） was more than that of controls （286） （P 〈 0.05 ）. No complications occurred in the staining group while hemorrhage of presacral venous plexus occurred in 2 cases, urinary retention in 3 cases, sexual disturbance in 1 case in the routine radical rectal excision group. Conclusion The mesorectums can be showed clearly by injecting methylthioninium chloride into superior rectal arteries in radical operations of rectal cancers. This procedure can avoid ureteral and the presacral venous plexus injuries during operation and increase detectable number of lymph nodes.

关 键 词：直肠肿瘤 癌 美蓝染色 

分 类 号：R735.3[医药卫生—肿瘤]