生物可降解吻合环、吻合器在右半结肠切除术中的应用比较  

Application of biodegradable anastomosis ring and anastomat in right hemicolectomy:A comparative study

作　　者：马钊[1] 聂洁伟[1] 孙培春[1] 马冰[2] 李荣[2] 陈凛[2] 

机构地区：[1]河南省人民医院普通外科,河南郑州450001 [2]解放军总医院普通外科,北京100853

出　　处：《军医进修学院学报》2012年第7期728-729,共2页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的比较右半结肠切除术中生物可降解吻合环(BAR)、吻合器两种方法的吻合效果。方法回顾性分析我院87例右半结肠切除术,其中49例用吻合器吻合,38例用BAR吻合,比较二者术后吻合口瘘、吻合口狭窄、腹腔感染、术后肠梗阻、消化道出血、切口感染等的发生率及肠功能恢复时间、材料费用等。结果两种方法均无吻合口瘘、吻合口狭窄、腹腔感染、术后肠梗阻等发生。吻合器法中1例出现下消化道出血、3例切口感染,BAR法中2例切口感染,差异均无统计学意义。吻合器法肠功能恢复时间平均为3.5d,BAR法肠功能恢复时间平均为3.1d,差异无统计学意义,但BAR法肠功能恢复时间明显早于吻合器法。吻合器法费用(管状吻合器加闭合器)平均约5 231元人民币,BAR约3 427元人民币。结论生物可降解吻合环在右半结肠切除术中的应用与管状吻合器同样安全可靠;比吻合器更有利于患者肠功能的恢复、更经济实用。Objective To compare the anastomosis effects of biodegradable anastomosis ring（BAR） and anastomat in right hemicolectomy. Methods Eighty-seven patients who underwent right hemicolectomy in our hospital were retrospectively analyzed. Of these patients, 49 underwent anastomosis using anastomat, 38 underwent anastomosis using BAR. The incidence of anastomosis fistula and stenosis, abdominal infection, postoperative ileus, gastrointestinal hemorrhage, incision infection, recovery time of intestinal function, and material cost were compared between the two intestinal anastomosis procedures. Results No anastomosis fistula and stenosis, abdominal infection, postoperative ileus occurred in all the patients. Lower gastrointestinal hemorrhage and incision infection were observed in 1 and 3 patients respectively after anastomosis with anastomat, and incision infection occurred in 2 patients after anastomosis with BAR with no significant difference. The recovery time of intestinal function was 3 A days and 3.5 days respectively after anastomosis with BAR and anastomat with no significant difference. However, the recovery time of intestinal function was shorter after anastomosis with BAR than after anastomosis with anastomat. The average cost for the anastomosis with BAR and anastomat was about 3 427 and 5 231 RMB Yuan, respectively. Conclusion BAR is as safe as anastomat when they are used for anastomosis in right hemicolectomy. However, it is more beneficial to the recovery of intestinal function and more economical than anastomat.

关 键 词：生物可降解吻合环 吻合器 右半结肠切除术 

分 类 号：R612[医药卫生—外科学]