低位三管引流预防梗阻性直肠癌急诊一期切除吻合术后吻合口瘘的效果  

Effects of drainage by three lower tubes on primary anastomosis after resection for rectal cancer

作　　者：吴印爱[1] 王志伟[1] 刘献棠[1] 聂晨阳[1] 杨慧[1] 易娜[1] 

机构地区：[1]广州军区广州总医院附属157医院普通外科,广东广州510510

出　　处：《中国现代医学杂志》2011年第18期2184-2186,共3页China Journal of Modern Medicine

摘　　要：目的观察低位三管引流预防梗阻性直肠癌急诊一期切除吻合术后吻合口瘘的效果。方法将1990年1月～2009年1月该院收治的158例梗阻性直肠癌患者按术后引流方式的差异分为两组。低位三管引流组术中经肛门于肠腔内放置两引流管,经肛管旁放置一盆腔引流管。对照组仅经肛管旁放置一盆腔引流管。对两组患者的术后并发症进行对比分析。结果切口感染、腹腔感染和吻合口瘘发生率方面,引流组分别为11.61%(13/112)、4.46%(5/122)和2.68%(3/112),对照组分别为10.70%(5/46)、19.57%(9/46)和15.21%(7/46)。引流组腹腔感染和吻合口瘘的发生率均显著低于对照组(P<0.05),两组间切口感染的发生率无显著性差异(P>0.05)。结论低位三管引流能有效地预防直肠癌梗阻急诊一期切除吻合术后吻合口瘘及腹腔感染的发生。[ Objective ] To investigate the effects of drainage by three lower tubes in preventing anastomotic leakage after emergency rectal resection with primary anastomosis for obstructive rectal carcinomas. [Methods] During the period of January 1990 to January 2009, 158 patients with obstructive rectal carcinomas underwent emergency rectal resection with primary anastomosis. They were allocated to two groups. In the drainage group, two tubes were placed in the colonic cavity, and one tube was placed in the presacral cavity. The postoperative complications of two groups were compared. [Results] There were 5 cases （10.70%） of wound infection, 9 cases （19.57%） of intraabdominal infection, and 7 cases （15.21%） of anastomotic leakage in the control group. In the drainage group, 13 cases （11.61%） of wound infection, 5 cases （4.46%） of intra-abdominal infection and 3 cases （2.68%） of anastomotie leakage occurred. The incidence of intra-abdominal infection and anastomotic leakage in the drainage group was statistically lower than that in control group respectively （P 〈0.05）. Both groups had a similar wound infection incidence （P 〉0.05）. [ Conclusion] The drainage by three lower tubes can effectively prevent anastomotic leakage and celiac infection after rectal emergency resection with primary anastomosis for obstructive rectal carcinomas.

关 键 词：直肠癌 梗阻 一期吻合 引流 吻合口瘘 

分 类 号：R735.37[医药卫生—肿瘤]