粗口径肛管和亚甲蓝混合液联用在预防直肠癌术后吻合口漏的临床研究  

Effect of combined application of large-calibre anal tube and methylene blue mixture in preventing colorectal anastomosis leakage

作　　者：廖传文[1] 曹虹[1] 胡淑琴[1] 刘伟中[1] 

机构地区：[1]江西省人民医院普外科,南昌330006

出　　处：《江西医药》2010年第10期961-963,共3页Jiangxi Medical Journal

摘　　要：目的探讨联合应用粗口径（直径1.0cm）肛管和亚甲蓝＋利多卡因＋布比卡因混合液肛周封闭在预防直肠癌前切除术后吻合口漏中的应用价值。方法回顾性分析2007年1月~2010年3月期间施行的134例经腹直肠癌前切除术患者的临床资料,治疗组62例,联合应用粗口径肛管及亚甲蓝＋利多卡因＋布比卡因混合液肛周封闭;对照组72例,未应用肛管及混合液肛周封闭。结果治疗组术后发生吻合口漏2例（3.22%）。对照组术后发生吻合口漏6例（8.33%）,两者术后吻合口漏发生率差异有统计学意义（P〈0.05）。其中6例吻合口漏经保守治疗痊愈,2例行横结肠造瘘粪便转流术治愈,无围手术期死亡病例。结论联合应用粗口径肛管引流和亚甲蓝混合液肛周封闭能够有效预防直肠癌前切除术后吻合口漏的发生,增加手术安全性。Objective To investigate the combined application of large caliber（diameter 1.0cm） transanal tube drainage and methylene blue ＋ lidocaine ＋ bupivacaine mixture of anal blocking in prevention of anastomotic leakage following anterior resection for rectal cancer.Methods Clinical datas of 134 consecutive patients undergone anterior resection for rectal cancer in our department from January 2007 to March 2010 were analyzed retrospectively.Results The anastomotic leakage rate was 3.22%（2/62） and 8.33%（6/ 72） in patients with or without receiving large caliber transanal tube drainage and methylene blue ＋ lidocaine ＋ bupivacaine mixture respectively.The anastomotic leakage rate was significantly decreased in treatment group after anterior resection for rectal cancer.Six cases of anastomotic leakage were treated conservatively and the other two cases received transverse colostomy.No peri-operative death occurred in this series.Conclusion Large caliber transanal tube drainage and methylene blue＋lidocaine＋bupivacaine mixture have the effect of proventing rectal anastomosis leakage.

关 键 词：直肠癌前切除术 吻合口漏 粗口经肛管 亚甲蓝混合液 

分 类 号：R735.37[医药卫生—肿瘤]