单、双器械吻合用于直肠癌全直肠系膜切除术对术后吻合口漏及腹腔引流液中CRP水平的影响研究  

The effect of single or double stapling technique on postoperative anastomotic leakage and CRP level in abdominal drainage in patients receiving total mesorectal excision for rectal cancer

作　　者：聂伟[1] Nie Wei(Department of Anal ＆ Intestinal Surgery,Wanbei Coal-Electricity Group General Hospital,Suzhou,Anhui,234000,China)

机构地区：[1]皖北煤电集团总医院肛肠外科,安徽宿州234000

出　　处：《结直肠肛门外科》2018年第4期367-370,共4页Journal of Colorectal & Anal Surgery

摘　　要：目的研究单、双器械吻合用于直肠癌全直肠系膜切除术(TME)对术后吻合口漏和腹腔引流液CRP水平的影响。方法回顾性分析本院120例接受TME直肠癌患者的临床病历资料,根据手术方式不同分为双器械吻合联合TME组(观察组,n=60)和单器械吻合联合TME组(对照组,n=60)。比较两组手术基本情况和吻合口漏发生情况,记录术后腹腔引流液CRP水平。结果观察组术中出血量少于对照组,手术时间、住院时间及术后首次肛门排气时间较对照组均缩短,差异均有统计学意义(均P<0.05)。观察组术后吻合口漏发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后第3 d时腹腔引流液中CRP水平低于对照组,差异有统计学意义(P<0.05)。发生吻合口漏组的患者术后第3 d腹腔引流液中CRP水平高于未发生吻合口漏组,差异有统计学意义(P<0.05)。结论与单器械吻合技术相比,双器械吻合技术用于TME有助于降低直肠癌患者术后吻合口漏发生率,缩短术后康复时间,术后腹腔引流液中CRP水平对防治吻合口漏有一定的参考意义。Objective To investigate effect of single or double stapling technique on postoperative anastomotic leakage and CRP level in abdominal drainage in patients receiving total mesorectal excision（TME） for rectal cancer. Methods The clinicopathological data of 120 patients receiving TME for rectal cancer in our hospital were retrospective analyzed. Based on the surgical methods, patients were divided into double stapling technique combined with TME group（treatment group, n = 60） and single stapling technique combined with TME group（control group, n = 60）. Indices related to the operation, the occurrence of anastomotic leakage were compared between the two groups. The CRP levels of abdominal drainage after operation were recorded. Results The amount of intraoperative bleeding was significantly less, and operation duration, duration of hospitalization and time to first anal exhaust were significantly shorter in the treatment group than in the control group（P〈0.05）. Incidence of anastomotic leakage was significantly lower in the treatment group than in the control group（P〈0.05）. The CRP level of abdominal drainage at the 3 rd day after operation was significantly lower in the treatment group than in the control group（P〈0.05）. The CRP level of abdominal drainage in patients with anastomotic leakage after operation was significantly higher than those without anastomotic leakage（P〈0.05）. Conclusion Compared with single stapling technique, double stapling technique was effective in reducing anastomotic leakage after TME, and shortening time to postoperative recovery. The level of CRP in abdominal drainage fluid might be a good indicator for preventing and treating anastomotic leakage.

关 键 词：器械吻合 全直肠系膜切除术 吻合口漏 腹腔引流液 CRP 

分 类 号：R735.3[医药卫生—肿瘤]