吻合环及传统末端吻合用于直肠癌保护性回肠造口术对患者术后恢复的影响  

Effect of anastomotic ring and traditional end to end anastomosis on postoperative recovery of rectal cancer patients after protective ileostomy

作　　者：李秦 李琳 LI Qin;LI Lin(Department of Gastroenterology, Xijing Hospital, Air Force Military Medical University, Shaanxi, Xi′an, 710032;Department of Hepatobiliary and Pancreatic Surgery, Xijing Hospital, Air Force Military Medical University, Shaanxi, Xi′an 710032)

机构地区：[1]空军军医大学西京医院肠胃外科,710032 [2]空军军医大学西京医院肝胆胰腺外科,710032

出　　处：《现代消化及介入诊疗》2020年第3期315-319,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：陕西省科学技术研究发展计划项目(2018SF-337)。

摘　　要：目的研究吻合环及传统末端吻合用于直肠癌保护性回肠造口术对患者术后恢复的影响。方法纳入2017年3月至2019年3月于空军军医大学西京医院收治的124例直肠癌患者为对象,按照抽签随机方法分为两组,各62例。其中对照组行传统保护性末端回肠造口术,观察组实施吻合环复合装置保护性回肠造口术。观察两组手术相关指标(包括手术操作时间、住院时间),分析两组手术并发症发生情况(包括吻合口瘘、造口相关并发症),并分析对照组患者术后还纳情况。结果两组所有患者均顺利完成造口手术。观察组手术操作时间显著长于对照组(P<0.05),但住院时间较对照组比较差异无统计学意义(P>0.05)。观察组造口相关并发症发生率为29.03%,显著低于对照组的61.29%(P<0.05);观察组吻合口瘘发生率为8.06%,对照组吻合口瘘发生率为6.45%,差异无统计学意义(P>0.05)。术后所有患者均随访6个月,随访期间无失访病例。对照组患者中,第1次术后3月还纳者占32.26%,术后6月还纳者占61.29%,未还纳者占6.45%。结论与传统保护性末端回肠造口术比较,采用吻合环复合装置保护性回肠造口术更利于直肠癌患者术后早期康复,造口相关并发症少,无需二次还纳,临床应引起足够重视。Objective To study the effect of anastomotic ring and traditional end to end anastomosis on the postoperative recovery of rectal cancer patients.Methods 124 rectal cancer patients admitted to our hospital from March 2017 to March 2019 were randomly divided into two groups,62 cases in each group.The control group received traditional protective terminal ileostomy,and the observation group received protective ileostomy with anastomotic ring compound device.The operation related indexes(including operation time and hospitalization time)were observed,and the complications(including anastomotic leakage and stoma related complications)were analyzed,and the postoperative recovery of patients in the control group was analyzed.Results All patients in the two groups successfully completed the stoma operation.The operation time in the observation group was significantly longer than that in the control group(<0.05),but the difference in the length of hospital stay was not statistically significant(>0.05).The incidence of stoma related complications in the observation group was 29.03%,significantly lower than 61.29%in the control group(<0.05);The incidence of anastomotic fistula was 8.06%in the observation group and 6.45%in the control group,with no statistically significant difference(>0.05).All patients were followed up for 6 months after surgery,during which no patients were lost to follow-up.Among the patients in the control group,32.26%were still enrolled 3 months after the first operation,61.29%were still enrolled 6 months after the operation,and 6.45%were not.Conclusion Compared with the traditional protective terminal ileostomy,the protective ileostomy with the composite device of anastomotic ring is more conducive to the early recovery of rectal cancer patients after operation,with less complications related to the stoma,and no need to return it twice,so it should be paid enough attention in clinical practice.

关 键 词：直肠癌 吻合环 传统保护性末端回肠造口术 保护性末段回肠造口术 

分 类 号：R735.37[医药卫生—肿瘤] R574[医药卫生—临床医学]