可分解吻合环和手工缝合在肠道吻合中的应用对照研究  

A comparative study on the application of biofragmentable anastomosis ring and manual-suture in intestinal anastomosis

作　　者：张育超[1] 杨斌[1] 刘剑文[1] 陈国星[1] 赖东明[1] 陈双[1] 

机构地区：[1]中山大学孙逸仙纪念医院胃肠外科,广州510120

出　　处：《岭南现代临床外科》2008年第2期94-95,98,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的比较可分解吻合环(BAR)与常规手工缝合在肠道吻合手术中的应用价值。方法对我院2001年12月至2007年12月收治行肠切除并吻和180例病例采用两种手术方法并分为两组,其中吻合环组(BAR组)92例,手工缝合组88例。术后分别记录肠道功能恢复时间,与吻合口有关的并发症发生等情况。结果BAR组死亡1例,但与手术无关。BAR组有1例发生术后吻合口瘘,手工缝合组2例,BAR组发生不完全性吻合口梗阻7例,手工缝合组2例,两组间有显著性差异(P<0.05)。术后肠道功能恢复时间分别为BAR组27.2±5.6h,手工缝合组49.6±8.7h,两组间存在显著性差异(P<0.01)。吻合口炎症发生情况BAR组1例,手工缝合组11例,两组间有显著性差异(P<0.01)。结论BAR是一种安全有效,可标准化的肠道吻合方法,特别是对急诊的高危病例。Objective To compare the application of biofragmentable anastomosis ring and conventional manual suture in intestinal anastomosis. Methods 180 patients undergoing intestinal resection with primary anastomosis were divided into a manual suture group （control group）and biofragmenfable anastomosis ring group （BAR group）. The anastomoses of 92 cases enrolled in the BAR group was performed with BAR, whereas the other 88 cases in manual suture group were done by standard double layer suture. The restoration time of bowel functions, post-operative complications of anastomotic leaks, bleeding and obstruction were recorded in each group. Results A dead case was recorded in BAR group, but was not related to anastomotic problems. Anastomotic leaks occurred in 1 case in BAR group and 2 cases in manual group. 7 cases incomplete obstruction oeeured in BAR group and 2 cases in manual suture group respectively （P 〈 0.05）. Post-operative bowel restoration time was 27.2±5.6 h and 49.6±8.7 h respectively,the difference was statistically signifieant（P 〈 0.01）. The anastomtie inflammatory reaction oeeured 1 ease （ 2.22% ） in BAR group and l l cases in manual group, the difference was statistically signifieant（P 〈 0.01）. Conclusion BAR is a safe and effective device in intestinal anastomosis, especially in emergency patients with high-risks. It may be applied as a standard anastomotie method.

关 键 词：可分解生物肠吻合环 肠吻合 

分 类 号：R656.7[医药卫生—外科学]