经肛门放置蕈状管对低位直肠癌切除术术后吻合口瘘预防效果的研究  

A research of postoperative anastomotic fstula prevention by fungusform canal placement through the anus in rectal cancer resection

作　　者：赵为民[1] 刘林[1] 方法[1] 杨新辉[1] 黄晓玲[2] 

机构地区：[1]新疆医科大学附属肿瘤医院胃肠外科,乌鲁木齐830000 [2]新疆维吾尔自治区人民医院消化科,乌鲁木齐830001

出　　处：《中国医学前沿杂志（电子版）》2016年第6期188-190,共3页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的 观察经肛门放置蕈状管对直肠癌切除术术后吻合口瘘的预防效果,为临床治疗提供参考。方法 选取2010年1月至2015年9月本院诊治的549例低位直肠癌患者为研究对象,随机分为试验组（275例）和对照组（274例）。试验组患者采取经肛门放置蕈状管疗法,对照组患者行油纱条塞肛,比较分析两组患者术后吻合口瘘发生率及直肠静息压力情况。结果 对照组患者吻合口瘘发生率明显高于试验组（χ^2=8.220,P=0.004）;试验组Dukes分期为B期的患者吻合口瘘发生率明显低于对照组（P〈0.05）;试验组肿瘤直径≥5 cm的患者吻合口瘘发生率明显低于对照组（P〈0.05）;试验组患者平均直肠静息压明显低于对照组（t=7.421,P=0.003）。结论 经肛门放置蕈状管可显著降低低位直肠癌切除术术后吻合口瘘的发生率,具有较好的安全性,对肿瘤直径≥5 cm者疗效更明显。Objective To observe the prevention effect of anus fungusform canal placement on postoperative anastomotic fistula resection in rectal cancer,and to provide reference for clinical treatment. Method 549 cases of rectal cancer patients diagnosed and treated in our hospital from January 2010 to September 2015 were selected as the research objects, and they were randomly divided into experimental group and control group. Experimental group patients received fungusform canal placed therapy, and control group patients were given article sand plug anal treatment. Comparative analyzed the incidence of anastomotic fistula and rectal resting pressure situation between the two groups. Result The incidence of anastomotic fistula of control group were significantly higher than experimental group （χ^2 = 8.220, P = 0.004）. The anastomotic fistula incidence of Dukes B stage patients in experimental group had significantly decreased when compared to control group （P 〈 0.05）. To patients whose tumor diameter ≥ 5 cm, the incidence of anastomotic fistula in experimental group was 11.01%, while the control group was 22.22%, the difference was statistically significant （P 〈 0.05）. The postoperative rectal resting pressure of experimental group had significantly decreased when compared to control group （t = 7.421, P = 0.003）. Conclusion The incidence of anastomotic fistula in rectal cancer resection patients can be significantly reduced after anal fungusform canal placement with a fairly good safety, and the curative effect is more obvious in patients whose tumor diameter are ≤ 5 cm.

关 键 词：蕈状管 直肠癌 吻合口瘘 

分 类 号：R735.37[医药卫生—肿瘤]