人工肛门制作方法探讨  

Discussion of fabrication of artificial anus

作　　者：朱群[1] 陈虎[1] 张凯欣[1] 祖连平[1] 秦琴[1] 赵以模[1] 

机构地区：[1]泗洪县人民医院普外科,江苏泗洪223900

出　　处：《中国肿瘤外科杂志》2011年第2期83-85,共3页Chinese Journal of Surgical Oncology

摘　　要：目的 探讨直肠癌Miles手术人工肛门制作的合理性、实用性和可操作性.方法 选择183例须行Miles手术的直肠癌患者,并在术前按双盲法随机分成改良造口组和传统造口组.改良造口组94例应用Goligher结肠造口法并将腹壁外结肠管留长至5～7 cm（腹茎）,传统造口组89例仍用传统手术造口法.比较两组术后造口旁皮肤及造口黏膜感染情况、造口旁疝的发生率、排便习惯恢复时间、大便清除难易度等.结果 改良造口组无1例出现造口旁疝、皮肤溃疡、湿疹及感染,2个月内即可恢复排便习惯,粪便不接触皮肤,造口清理方便.结论 改良腹壁造口法较传统造口法具有操作简单、并发症少、术后排便习惯恢复快、大便易清除等优点.Objective To explore the rationality, practicability and controllability of the fabrication of artificial anus in Miles operation on rectal cancer. Methods 183 cases suffering from the disease who have to be treated by Miles operation were selected, these cases being randomly divided into modified ostomy group and traditional ostomy group according to hi-blind method before operation. The method of Goligher colon ostomy was applied in the 94 cases of modified ostomy group, with the colon reserved 5 -7 cm （abdominal stalk type） outside of abdominal wall, traditional ostomy was applied in the 89 cases of traditional ostomy group. From the comparison of the 2 post-operational groups about the infectional circumstances of the dermis and the mucosa around ostomy, the incidence of parastomal hernia, the recovery time of bowel habits, the difficulty of clearance of stool, and so on. Results We can see that there were no parastomal hernia, skin ulcers and eczema occurred in modified ostomy group, bowel habits recovered within 2 months, the stool easily cleared and having no contact with skin. Conclusions We can conclude that modified ostomy of abdominal wall is a kind of technique with the advantages of simple proeedure, little complication, fast recovery of bowel habit and easy cleaning of stool prior to the traditional ostomy method.

关 键 词：直肠癌 MILES手术 人工肛门 Goligher结肠造口法 传统造口法 结肠造口灌洗 

分 类 号：R473.73[医药卫生—护理学]