左半结肠癌梗阻急诊一期切除吻合术中两种肠道清洁方式的比较  

Comparison between the two ways of intraoperative bowel preparation in emergency one-stage resection and anastomosis for malignant left-semicolon obstruction

作　　者：杨爱国[1] 何宁[1] 陈智勇[1] 

机构地区：[1]解放军第一七五医院普外科,福建漳州363000

出　　处：《腹部外科》2010年第5期297-298,共2页Journal of Abdominal Surgery

摘　　要：目的探讨左半结肠急性恶性梗阻选择性一期切除吻合的简单、有效的术中肠道准备方式。方法 2000年1月至2009年12月收治左半结肠急性恶性梗阻63例,其中行选择性左半结肠一期切除吻合31例。根据术中肠道准备方式不同,把31例随机分为术中肠减压+结肠灌洗16例(A组)、单纯肠减压15例(B组),记录2组平均手术时间,术后吻合口漏发生率、手术感染率及手术死亡率。结果 A组手术时间为(230±20)min,手术感染率为31.3%。B组手术时间为(150±10)min,手术感染率为26.7%,两组均无吻合口漏及手术死亡病例。两组比较,平均手术时间差异有统计学意义(P<0.01),手术感染率差异无统计学意义(P>0.05)。结论单纯充分肠减压在左半结肠急性梗阻选择性一期切除吻合的应用,是一种简单、有效、安全的术中肠道准备方式。Objective To investigate the simple and effective method of intraoperative bowel preparation in one-stage resection and anastomosis for acute malignant left-semicolon obstruction. Methods The clinical data of 31 cases of acute left-semicolon obstruction treated with one-stage resection and anastomosis were analyzed from Jan. 2000 to Dec. 2009 in our hospital. Sixteen cases （group A） received intraoperative irrigation of colon and decompress, and the remaining 15 cases（group B） were subjected to intraoperative single bowel decompression. Results The mean operation time in groups A and B was （230 ±20） min and（150 ± 10） min（P〈0. 01）. The operative infection rate in groups A and B was 31.3 % and 26. 7 %（P〉0. 05）. There were no anastomotic leakage and surgical deaths in the two groups. Conclusion Single bowel decompression was a simple and effective method of intraoperative bowel preparation in selective one-staged resection and anastomosis for acute malignant left-semicolon obstruction.

关 键 词：肠梗阻 减压 灌洗 

分 类 号：R735.35[医药卫生—肿瘤]