自制双套管持续冲洗治疗腹腔镜低位直肠癌根治术后吻合口瘘  

Continuous irrigation and drainage through self-made double pelvic drainage tube for anastomotic fistula after laparoscopic low anterior resection

作　　者：余加和[1] 黄项武[1] 董志勇[2] 林芳英[1] 王瑜[3] 

机构地区：[1]福建莆田学院附属医院肛肠外科,福建莆田351100 [2]福建莆田学院附属医院胃肠外科,福建莆田351100 [3]中国人民解放军南京军区福州总医院普通外科研究所,福建福州350025

出　　处：《河北医科大学学报》2015年第4期408-411,共4页Journal of Hebei Medical University

摘　　要：目的探讨腹腔镜低位直肠癌根治术后骶前放置自制双套管持续冲洗负压引流治疗吻合口瘘的方法,观察其效果,以期为临床吻合口瘘的治疗以及科研提供参考和依据。方法在腹腔镜低位直肠癌根治术中预先于骶前吻合口下方放置自制双套管,当术后发现吻合口瘘后,及时持续冲洗负压引流,重点观测冲洗后引流液的出入量、引流液的颜色和性质等,观察患者临床症状,记录瘘发生和愈合时间以及住院时间。结果经过自制双套管持续冲洗引流后,198例腹腔镜低位直肠癌根治术后发生吻合口瘘的9例患者均痊愈出院,相对于以往传统方法,它缩短了吻合口瘘愈合时间,降低了吻合口瘘后病死率。结论自制双套管持续冲洗并引流是治疗吻合口瘘的可靠方法之一,简单有效,但目前仍缺少客观的大样本的临床随机对照试验证据进一步支持。Objective To examine the effect of continuous irrigation and drainage through self-made double pelvic drainage tube in treatment of anastomotic fistula for reference in clinical research.Methods The self-made double pelvic drainage tube was positioned in advance under the anastomotic to prevent fistula in patients undergoing laparoscopic low anterior resection.Timely and continuous irrigated the pelvic when the fistula happened.The observation mainly included fluids,quantity,clinical symptom,the time of fistula and recovery.Results Under the continuous irrigation and drainage through self-made double pelvic drainage tube,9 of 198 patients after laparoscopic low anterior resection all recovered.Compared with the conventional intervention,the method shortened the healing time of fistula,and the mortality decreased.Conclusion The continuous irrigation and drainage through self-made double pelvic drainage tube in treatment of anastomotic fistula is effective and economical.But,there is still lacking of support by randomized controlled trial.

关 键 词：直肠肿瘤 吻合口瘘 灌洗疗法 

分 类 号：R735.37[医药卫生—肿瘤]