末段回肠外置术(不切开)在腹腔镜直肠癌低位前切除术中的意义  

Significance of Terminal Ileum Exteriorization(Non-incision) in the Laparoscopic Low Anterior Resection

作　　者：李俊 LI Jun(Department of General Surgery,Shanwei People＇s Hospital,Shanwei,Guangdong Province,516600 China)

机构地区：[1]汕尾市人民医院普外科,广东汕尾516600

出　　处：《中外医疗》2018年第11期87-89,共3页China & Foreign Medical Treatment

摘　　要：目的分析末段回肠外置术(不切开)在腹腔镜直肠癌低位前切除术(L-LAR)治疗直肠癌中的应用价值。方法随机选取该院于2016年2月—2017年4月期间收治的100例直肠癌患者,随机分为观察组和对照组,每组50例,对观察组实施L-LAR+末段回肠外置术治疗,对对照组实施L-LAR+保护性肠造瘘治疗,分析并观察两组患者术后第7天的吻合口漏相关指标检测结果以及术后相关指标的检测结果。结果术后第7天观察组血常规中红细胞计数(4.31±0.38)×1012、白细胞计数(10.06±0.98)×109、血红蛋白(115.52±4.26)g/L,CRP(99.96±12.11)μg/L,P(73.34±3.90)次/min检测结果优于对照组(t=7.155、4.314、7.269、7.971、3.354,P<0.05)。观察组术后首次自主排气排便时间(2.04±0.19)d、首次进食时间(24.38±3.72)h、首次下床时间(2.67±0.38)d、引流管拔除时间(2.28±0.44)d及住院时间(9.89±1.14)d短于对照组(t=13.192、7.193、4.832、4.488、7.227,P<0.05)。结论末段回肠外置术(不切开)在L-LAR中的应用,能够发挥与保护造口相同的吻合口漏控制效果,且不会增加患者发生吻合口瘘的风险,利于患者术后早日康复。Objective To analyze the application value of terminal ileum exteriorization（non-incision） in the laparoscopic low anterior resection. Methods 100 cases of patients with rectal cancer admitted and treated in our hospital from February2016 to April 2017 were random selected and randomly divided into two groups with 50 cases in each, the control group used the L-LAR and protective enterostomy for treatment, while the observation group used the L-LAR and terminal ileum exteriorization for treatment, and the test results of anastomotic leakage related indicators in 7 d after surgery and test results of postoperative related indicators of the two groups were analyzed and observed. Results The red-cell count（4.31±0.38） ×1012, leucocyte count（10.06 ±0.98） ×109, hemoglobin（115.52 ±4.26） g/L,CRP（99.96 ±12.11） μg/L,P（73.34 ±3.90）times/min in the blood routine test in the observation group in 7 d after surgery were better than those in the control group,（t=7.155,4.314,7.269,7.971,3.354,P〈0.05）, and the first self-exhaust defecation time（ 2.04±0.19） d, first dieting time（24.38±3.72） h, first time to get out of bed（2.67 ±0.38） d, drainage tube removal time（2.28 ±0.44） d, length of stay（9.89±1.14） d in the observation group after surgery were shorter than those in the control group（t=13.192,7.193,4.832,4.488,7.227,P〈0.05）.Conclusion The application of terminal ileum exteriorization（non-incision） in the laparoscopic low anterior resection can obtain an anastomotic leakage control effect that is the same as the protective stoma, without increasing the occurrence risk of anastomosis fistula, which is beneficial to the early recovery after surgery.

关 键 词：末段回肠外置术 腹腔镜直肠癌低位前切除术 吻合口漏 

分 类 号：R735[医药卫生—肿瘤]