皮下持续负压引流预防结直肠癌伴肥胖患者剖腹根治术后切口脂肪液化及感染:单中心回顾性分析  

Subcutaneous continuous negative pressure drainage in the prevention of postoperative incision fat liquefaction and infection in obese colorectal cancer: a single-center retrospective analysis

作　　者：吕波[1] 王兵[1] 袁家天[1] 范俊[1] 邢莎莎[2] 张鑫[1] 冷书生 李叔强[1] 强正宏[1] 曾云龙[1] 李俊[1,2] 

机构地区：[1]成都大学附属医院普外科,610081 [2]成都大学附属医院中心实验室,610081

出　　处：《中华普通外科学文献（电子版）》2016年第2期103-107,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：成都大学校青年基金项目(2012XJ25;2015XJZ33)

摘　　要：目的研究皮下持续负压引流（CNPD）对预防结直肠癌（CRC）伴肥胖患者行剖腹根治术后切口脂肪液化及感染的作用。方法回顾性分析本院2005年1月至2015年6月行剖腹根治性切除术的CRC伴肥胖患者210例,统计行CNPD患者（引流组,91例）及直接切口缝合患者（无引流组,119例）切口脂肪液化及感染发生率、拆线时间、住院时间以及术后肠梗阻发生率。结果引流组及非引流组患者切口脂肪液化率分别为3.3%、10.9%（χ^2=4.236,P=0.039）,感染率分别为2.2%、9.2%（χ^2=4.408,P=0.036）。引流组术后拆线时间及住院时间均较非引流组短（t=2.537、2.032,P=0.027、0.045）。引流组患者术后发生肠梗阻比例更低（5.5%vs 15.1%,χ^2=4.905,P=0.027）。亚组分析提示两组合并糖尿病患者脂肪液化率分别为4.0%、27.0%（χ^2=5.421,P=0.020）,切口感染率分别为4.0%、24.3%（χ^2=4.556,P=0.033）,差异有统计学意义。结论皮下CNPD能够有效降低肥胖型CRC患者术后切口脂肪液化及感染率,缩短拆线时间、住院周期,且能够降低术后肠梗阻发生率,对于合并糖尿病的肥胖型CRC患者,CNPD预防切口脂肪液化及感染有明显优势。Objective To study the subcutaneous continuous negative pressure drainage（CNPD）for the prevention of incision fat liquefaction and infection in colorectal cancer（CRC） patients with obesityundergoing open radical resection. Methods A retrospective analysis of 210 obese patients with CRCreceiving radical resection in our hospital from January 2005 to June 2015 were carried out to compareincision fat liquefaction and infection rate, clearing time, hospitalization interval and incidence ofpostoperative intestinal obstruction between patients of CNPD（drainage group, 91 cases） and non-CNPD（non-drainage group, 119 cases）. Results In drainage and non-drainage group, fat liquefaction rates were3.3% vs 10.9%（χ~2=4.236, P=0.039）, the rate of incision infection were 2.2% vs 9.2%（χ~2=4.408, P=0.036）.The postoperative clearing time and hospitalization interval of drainage group were shorter than non-drainage group（t=2.537, 2.032, P=0.027, 0.045, respectively）. The proportion of intestinal obstruction waslower in drainage group than that in non- drainage group（5.5 % vs 15.1%, χ~2=4.905, P=0.027）. Theliquefaction rates of obese patients with diabetes mellitus were 4.0% vs 27.0%（χ~2=5.421, P=0.020）, andincision infection rate was 4.0% vs 24.3%（χ~2=4.556, P=0.033） in two groups. Conclusions CNPD can effectively reduce incision fat liquefaction and infection rate, shorten the clearing time and hospitalizationperiod, and may reduce the incidence of postoperative intestinal obstruction. For patients with diabetes,CNPD has obvious advantages on preventing incision fat liquefaction and infection.

关 键 词：结直肠肿瘤 引流术 剖腹手术 脂肪液化 切口感染 

分 类 号：R735.34[医药卫生—肿瘤]