圆形吻合器行末端回肠双腔造口的可行性研究  

The feasibility study of circular stapler used in dysfunctional loop ileostomy

作　　者：崔伟[1] 孙亮 陈纲 杨梅 李世拥 Cui Wei;Sun Liang;Cheng Gang;Yang Mei;Li Shiyong(Department of General Surgery,The Seventh Medical Center of PLA General Hospital,Beijing 100700,China;Bayi children’s Hospital,The Seventh Medical Center of PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心全军普通外科中心,100700 [2]解放军总医院第七医学中心儿科医学部,100700

出　　处：《中华普外科手术学杂志（电子版）》2020年第6期597-599,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：解放军军队后勤科研项目(CLJ17J022)。

摘　　要：目的探讨使用圆形吻合器行末端回肠双腔造口的可行性。方法选择2018年1月至2019年6月间收治的低位直肠癌保肛手术后需行末端回肠双腔造口术患者90例,采用随机数字表法选择45例为实验组(圆形吻合器行末端回肠双腔造口),45例患者为对照组(传统方法行末端回肠双腔造口)。采用SPSS11.5软件包进行统计学处理,围术期指标等计量资料以(±s)表示,独立t检验;患者满意度、造口相关并发症发生率、造口还纳相关并发症的发生率采用χ^2检验或Fisher确切概率检验,以P<0.05为差异有统计学意义。结果两组患者手术时间、术中出血量、术后进食时间、结直肠吻合口漏发生率相比差异无统计学意义(P>0.05)。实验组造口袋首次渗漏时间(3.54 d)显著长于对照组(2.04 d),患者满意度明显提高(P<0.05)。实验组造口相关并发症发生率(13.3%)较对照组(31.1%)明显降低(P<0.05)。两组造口还纳相关并发症的发生率(8.9%vs.8.9%)差异无统计学意义(P>0.05)。结论使用圆形吻合器行末端回肠双腔造口是安全可行的,患者满意度高,值得临床应用。Objective To study the feasibility of circular stapler used in temporary preventive dysfunctional loop ileostomy.Methods The 90 cases of low rectal cancer that received sphincter-saving surgery and dysfunctional loop ileostomy treated in our hospital were selected.They were randomly divided into two groups,each 45 cases.The circular stapler was used in the experimental group,and the traditional method was used in the control group.The clinical data were collected and analyzed with SPSS 11.5 statistical software.Perioperative indicators of the two groups were expressed as,and compared with independent t test.The incidence was examined by chi square test.The difference was statistically significant when P<0.05.Results No significant difference was noted between the two groups in terms of operative time,blood loss,postoperative eating time and the incidence of anastomotic leakage(P>0.05).The first leaked time of stoma bag after operation was significantly longer in the experimental group(3.54 d)which had a better satisfaction than in the control group(2.04 d)(P<0.05).The incidence of stoma-related complications of the experimental group(13.3%)was significantly lower than that of the control group(31.1%)(P<0.05).There were no significant differences between the two groups in the incidence of complications related to stoma closure(8.9%vs 8.9%)(P>0.05).Conclusions It is safe and feasible using the circular stapler in temporary preventive terminal ileum loop stoma.

关 键 词：圆形吻合器 末端回肠双腔造口 保肛手术 

分 类 号：R73[医药卫生—肿瘤]