结肠造瘘术两种开放方式术后恢复情况及并发症对比探讨  

Comparative discussion between postoperative recovery and complications of two opening methods of colostomy

作　　者：李世红[1] 刘雁军[1] 夏乡[1] 李云涛[1] 侯康[1] 罗丹[1] 

机构地区：[1]成都市第三人民医院普外二(胃肠)科,成都610000

出　　处：《西南国防医药》2015年第9期994-996,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的 比较结肠Ⅰ期开放造瘘术与Ⅱ期开放造瘘术方法的临床疗效。方法 采用病例对照研究的方法 ,回顾性分析我院自2010年1月-2012年1月收治的直肠癌或结肠梗阻坏死行结肠造瘘术病例55例,按造瘘术开放方式不同分为A、B两组,A组30例,采用Ⅰ期开放结肠造瘘术;B组25例,采用Ⅱ期开放结肠造瘘术。观察比较两组术后恢复情况、有无造瘘口或切口感染及术后3 d并发症情况;对两组进行2年随访,比较两组术后长期并发症情况。结果 两组术后开始进食时间、肠道开始排气时间和住院时间具有统计学差异（P〈0.01）,A组均优于B组,说明A组手术方式术后恢复情况优于B组;A组术后出现短期并发症的情况（术后腹胀痛、造瘘口或切口感染）均少于B组（P〈0.05或P〈0.01）;两组长期并发症（造瘘口回缩、造瘘口狭窄、造瘘口旁疝）比较无显著差异（P〉0.05）。结论 结肠Ⅰ期开放造瘘术具有患者术后康复较快,短期术后并发症发生比例较低的优势,是一种更为安全有效的结肠造瘘术。Objective To make comparison between the clinical curative effects of stage Ⅰ and Ⅱ opening colostomy. Methods Case control study was used to retrospectively analyze the 55 cases of rectal cancer or colon obstruction necrosis receiving colostomy between January 2010 and January 2012. Thirty cases receiving the stage Ⅰ opening colostomy were selected as group A. Twenty five cases receiving stage Ⅱ opening colostomy were selected as group B. Observation and comparison were made between the two groups in the postoperative recovery and whether there were stoma or incisional wound infection and the incidence of complications three days after the operation. Two-year follow-up was made in the two groups, and the postoperative long term complications between the groups were compared. Results There were significant differences between the group A and B in postoperative time of eating food, farting time, and hospital stay（P 〈 0.01）. Those indexes of group A were superior to those of group B, which indicated that the recovery after the operation in group A was superior to that in group B. The incidence of postoperative short term complications （abdominal distention and stoma or incisional wound infection） in group A was less than that in group B （P 〈 0.05 or P 〈 0.01）. There was no significant difference in the long term complications（parastomal retraction, stenosis, and hernia） between the two groups （P 〉 0.05）. Conclusion Stage Ⅰ opening colostomy has the advantages of fast recovery and less incidence of short term postoperative complications. It is a much safer and more effective method of colostomy.

关 键 词：结肠造瘘术 Ⅰ期开放 Ⅱ期开放 

分 类 号：R735.35[医药卫生—肿瘤]