预防性回肠造口对腹腔镜低位直肠癌术后吻合口瘘的影响  

Effect of prophylactic ileostomy on anastomotic leakage after laparoscopic low rectal cancer operation

作　　者：陈海德 陈龙林 陈钦盛 CHEN Hai-de;CHEN Long-lin;CHEN Qin-sheng(Shantou Chaoyang District Dafeng Hospital,Shantou 515154,China)

机构地区：[1]汕头市潮阳区大峰医院,515154

出　　处：《中国实用医药》2020年第12期27-29,共3页China Practical Medicine

摘　　要：目的观察预防性回肠造口对腹腔镜低位直肠癌术后吻合口瘘的影响。方法80例低位直肠癌患者,采取随机数字表法分为对照组与实验组,各40例。对照组进行腹腔镜手术治疗,实验组在对照组基础上实施预防性回肠造口术。比较两组患者术后恢复情况(术后首次下床时间、术后首次排气时间、术后输液总天数、住院总时长)及并发症发生情况。结果实验组患者术后首次下床时间、术后首次排气时间、术后输液总天数、住院总时长分别为(1.96±0.21)、(2.16±0.24)、(4.05±0.46)、(8.37±0.91)d,均短于对照组的(3.72±0.43)、(4.38±0.51)、(6.63±0.57)、(11.96±2.08)d,差异具有统计学意义(P<0.05)。实验组患者并发症发生率为2.50%,低于对照组的22.50%,差异具有统计学意义(P<0.05)。结论低位直肠癌患者采取腹腔镜手术治疗时,如实施预防性回肠造口术,可有效缩短患者术后恢复时间,更能有效的降低术后吻合口瘘的发生率,效果理想。Objective To observe the effect of prophylactic ileostomy on anastomotic leakage after laparoscopic low rectal cancer operation.Methods A total of 80 patients with low rectal cancer were divided into control group and experimental group by random number table method,with 40 cases in each group.The control group was treated by laparoscopic operation,and the experimental group was treated by prophylactic ileostomy on the basis of the control group.The postoperative recovery(first time off-bed after operation,first exhaust time after operation,infusion time after operation and hospitalization time)and occurrence of complications were compared between the two groups.Results The first time off-bed after operation,first exhaust time after operation,infusion time after operation and hospitalization time of the experimental group were(1.96±0.21),(2.16±0.24),(4.05±0.46)and(8.37±0.91)d respectively,which were shorter than those of the control group(3.72±0.43),(4.38±0.51),(6.63±0.57)and(11.96±2.08)d,and the difference was statistically significant(P<0.05).The incidence of complications of the experimental group was 2.50%,which was lower than that of the control group 22.50%,and the difference was statistically significant(P<0.05).Conclusion Prophylactic ileostomy for patients with low rectal cancer undergoing laparoscopic surgery can effectively shorten the postoperative recovery time and reduce the incidence of postoperative anastomotic fistulas,and the effect is ideal.

关 键 词：预防性 回肠造口 腹腔镜 低位直肠癌 吻合口瘘 

分 类 号：R735.37[医药卫生—肿瘤]