自闭式插管造瘘在低位直肠癌保肛手术的临床应用研究  

Clinical application of self-closing ileostomy in anus-preserving surgery for low rectal cancer

作　　者：付旭堂[1] 邵华[1] 陈芃芃 Xu-Tang Fu;Hua Shao;Peng-Peng Chen(Minimally Invasive Surgery Center,Pan’an County People’s Hospital,Jinhua 322399,Zhejiang Province,China)

机构地区：[1]磐安县人民医院外科微创中心,浙江省金华市322399

出　　处：《世界华人消化杂志》2020年第6期231-235,共5页World Chinese Journal of Digestology

摘　　要：背景低位直肠癌保肛手术在临床上越来越常见,人工造瘘术是直肠癌手术的常见辅助技术,传统人工造瘘术手术创伤较大,肠道功能恢复后需要再次手术封闭瘘口,操作繁琐且成本较高,遂对新式自闭式插管造瘘展开研究.目的观察低位直肠癌保肛手术应用自闭式插管造瘘的临床效果.方法选择2016-07/2018-07在我院消化外科行低位直肠癌保肛手术治疗的120例患者作为研究对象,按随机数表法分两组组,每组60例,均行直肠癌低位前切除术,对照组在术中行常规回肠保护性造口技术,观察组行自闭式插管造瘘技术,比较两组手术指标、并发症及生活质量.结果观察组带管时间26.59 d±3.81 d、住院时间12.01d±3.56 d相比对照组短,且造口袋更换次数1.09次/wk±0.30次/wk比对照组少(P<0.05);观察组并发症6.67%相比对照组26.67%更低(P<0.05);观察组术后躯体功能(92.41分±10.21分)、生理职能(76.82分±14.15分)、机体疼痛(90.11分±10.63分)等评分相比对照组高(P<0.05).结论低位直肠癌保肛手术应用自闭式插管造瘘能保护吻合口,减少造口并发症,缩短造口期,减少造口袋更换次数,效果良好.BACKGROUND Anus-sparing sturgery for low rectal cancer is becoming more and more common in clinical practice.Ileostomy is a common auxiliary technology for rectal cancer surgery.However,traditional ileostomy is traumatic.After the intestinal function is restored,the stoma needs to be closed again.And the cost is high,so research on the new self-closing ileostomy is of great significance.AIM To observe the clinical effects of self-closing ileostomy in anus-preserving surgery for low rectal cancer.METHODS A total of 120 patients who underwent anus-preserving sturgery for low rectal cancer at our hospital were selected from July 2016 to July 2018.The patients were divided into either a control group or an observation group using a random number:table.The control group underwent conventional protective ileostomy duing the operation,and the observation group underwent self-closing ileostomy.Surgical indicators,complications,and quality of life were compared between the two groups.RESULTS Compared with the control group,the observation group had shorter duration of colostomy(26.59 d±3.81 d) and length of hospitalization(12.01 d±3.56 d),and fewer times of pocket replacement(1.09 times/wk±0.30 times/wk)(P <0.05).The rate of complications in the observation group(6.67%) was significantly lower thar that in the control group(P <0.05).The scores of physical function(92.41 points±10.21 points),physical role physical(76.82 points±14.15 points),and bodily pain(90.11 points±10.63 points) in the observation group after operation were significantly better than those of the control group(P <0.05).CONCLUSION The application of self-closing ileostomy in anuspreserving surgery for low rectal cancer can protect the anastomotic site,reduce stoma complications,shorten the duration of ileostomy,and reduce the number of pocket changes.

关 键 词：自闭式插管造瘘 低位直肠癌 保肛手术 

分 类 号：R735.37[医药卫生—肿瘤]