肠系膜下动脉结扎部位对直肠癌手术疗效的影响  

The Effect of Different Ligation Sites in Inferior Mesenteric Artery on Therapeutic Effect in Rectal Cancer Surgery

作　　者：季恩敏[1] 张军[1] 李昌权[1] 李岗[1] 史伟[1] 于浩[1] 李光云[1] 田景中[1] JI Enmin;ZHANG Jun;LI Changquan;LI Gang;SHI Wei;YU Hao;LI Guangyun;TIAN Jingzhong(Department of Gastrointestinal Surgery,Bozhou People's Hospital,Bozhou 236800,Anhui,China)

机构地区：[1]安徽省亳州市人民医院胃肠外科,安徽亳州236800

出　　处：《贵州医科大学学报》2020年第9期1093-1096,共4页Journal of Guizhou Medical University

基　　金：2018年度安徽理工大学青年教师科学研究基金(QN2018126)。

摘　　要：目的:探讨不同肠系膜下动脉(IMA)结扎部位对直肠癌手术患者的效果。方法:选取直肠癌患者110例,根据IMA结扎部位分为A组(n=58)和B组(n=52),A组给予低位IMA结扎,B组给予高位IMA结扎;观察2组患者的手术时间、术中出血量、淋巴结清扫数目、肛门排气时间、排便功能、并发症及术后复发情况。结果:2组患者手术时间、术中出血量、淋巴结清扫数目比较,差异无统计学意义(P>0.05);A组患者肛门排气时间早于B组,差异有统计学意义(P<0.05);A组患者术后6个月时排便功能评分低于B组,差异有统计学意义(P<0.05);2组患者吻合口瘘、尿潴留和肠梗阻发生率比较,差异无统计学意义(P>0.05);2组患者术后复发率比较,差异无统计学意义(P>0.05)。结论:低位IMA结扎相较于高位IMA,在直肠癌手术中有较好的效果,具有并发症少等优点。Objective:To investigate the effect of different ligation sites in inferior mesenteric artery(IMA)on therapeutic effect in rectal cancer surgery.Methods:One hundred and ten patients with rectal cancer were selected.According to IMA ligation site,patients were divided into group A(n=58)and group B(n=52).Group A was given low IMA ligation,while group B were received high IMA ligation.The operation time,intraoperative blood loss,the number of lymph node dissection,anal exhaust time,defecation,complications and postoperative relapse were compared between the two groups.Results:There were no significant difference in operation time,the amount of bleeding and number of lymph node dissection between group A and group B(P>0.05).The anal exhaust started earlier in group A than in group B(P<0.05).At 6 months after operation,the defecation score was lower in group A than in group B.There was no significant difference in incidence of anastomotic leakage,urinary retention and intestinal obstruction between two groups(P>0.05).Moreover,relapse rate between group A and group B was similar.Conclusion:Compare with high IMA,low IMA ligation improves the effect of rectal cancer surgery and reduces complications.

关 键 词：肠系膜下动脉 结扎术 直肠肿瘤 临床效果 并发症 

分 类 号：R735.3[医药卫生—肿瘤]