经腹膜内乙状结肠造口术与经腹膜外乙状结肠造口术临床效果的比较  

Comparative on the clinical effects of intraperitoneal sigmoid colostomy and extraperitoneal sigmoid colostomy

作　　者：李泽灵 江薇 LI Zeling;JIANG Wei(Department of General Surgery,Jingdezhen No.1 People′s Hospital in Jiangxi Province,Jingdezhen333000,China)

机构地区：[1]江西省景德镇市第一人民医院普外科,江西景德镇333000

出　　处：《中国现代医生》2021年第4期46-49,共4页China Modern Doctor

基　　金：江西省景德镇市科技计划项目(20182SFZC062)。

摘　　要：目的观察经腹膜内、腹膜外两种结肠造口形式的并发症、术后出血、生活质量等情况。方法选取2018年6月至2019年6月我院收治的60例接受肛管、直肠下段恶性肿瘤切除术合并乙状结肠造口的患者,将所有患者分为经腹膜外组(n=30)与经腹膜内组(n=30);对比两组患者围术期手术时间、首次肛门排气时间、首次排便时间、术中出血量、并发症及生活质量情况。结果两组在手术时间、术中出血量、术后住院时间比较,差异无统计学意义(P>0.05)。经腹膜外组患者在首次肛门排气时间和首次排便时间,明显短于经腹膜内组,差异有统计学意义(P<0.05)。经腹膜内组的并发症总发生率为30.00%,经腹膜外组的并发症总发生率为3.33%,组间比较差异有统计学意义(P<0.05)。经腹膜外组的功能领域积分为(326.43±77.14)分,明显高于经腹膜内组的(262.71±48.65)分;经腹膜外组的症状领域积分为(110.76±43.28)分,明显低于经腹膜内组的(143.37±53.82)分,差异均有统计学意义(P<0.05)。结论与经腹膜内造口术相比,经腹膜外乙状结肠造口的并发症明显减少,且控便、排便能力更好,值得在临床治疗上推广。Objective To observe the complications,postoperative bleeding and quality of life of the two forms of intraperitoneal and extraperitoneal colostomy.Methods A total of 60 patients who underwent resection of malignant tumors of the anal canal and lower rectum combined with sigmoid colostomy who were admitted to our hospital from June 2018 to June 2019 were selected in this study.They were divided into two groups,the intraperitoneal group(n=30)and the extraperitoneal group(n=30);the perioperative operation time,time of first anal exhaustion,time of first defecation,intraoperative blood loss,complications and quality of life were compared between the two groups of patients.Results There was no difference between the extraperitoneal group and the intraperitoneal group in terms of operation time,intraoperative blood loss,and postoperative length of hospital stay.In terms of days of first anal exhaustion and days of first defecation,the time spent by patients in the extraperitoneal group were significantly lower than those in the intraperitoneal group,and the differences were statistically significant(P<0.05).The total complication rate in the intraperitoneal group was 30.00%,and the total complication rate in the extraperitoneal group was 3.33%.The difference was significant between the two groups(P<0.05).The functional area score in the extraperitoneal group was(326.43±77.14)points,which was higher than that of(262.71±48.65)points in the intraperitoneal group;the symptom area score in the extraperitoneal group was(110.76±43.28)points,which was lower than that of(143.37±53.82)points in the intraperitoneal group.The difference was significant between the two groups(P<0.05).Conclusion Compared with intraperitoneal colostomy,the complications of extraperitoneal sigmoid colostomy are significantly reduced,and the ability to control bowel movement and perform bowel movement is better.It is worthy of promotion in clinical treatment.

关 键 词：乙状结肠造口 经腹膜内 经腹膜外 造口并发症 

分 类 号：R735.37[医药卫生—肿瘤]