直肠癌会阴切口重建及肠造口关闭术中十字缝合法应用效果及安全性研究  

Study on the effect and safety of“cross”suture in reconstruction of perineal incision and closure of enterostomy for rectal cancer

作　　者：李晓和[1] 杨胜富[1] 粟业能 徐绍强 冯广革 LI Xiaohe;YANG Shengfu;SU YeNeng;XU Shaoqiang;FENG Guangge(Department of Colorectal and anal surgery,Yulin Red Cross Hospital,Yulin,Guangxi 537000,China;不详)

机构地区：[1]广西玉林市红十字会医院结直肠肛门外科,537000 [2]广西玉林市红十字会医院普外科,537000

出　　处：《临床外科杂志》2023年第6期528-532,共5页Journal of Clinical Surgery

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190131)。

摘　　要：目的分析直肠癌会阴切口重建及肠造口关闭术中十字缝合法应用效果及安全性。方法2019年1月~2022年1月本院收治的直肠癌腹会阴联合切除术中会阴切口重建和肠造口关闭术中腹部切口重建病人107例。分为造口传统组12例、造口十字组14例、重建传统组37例、重建十字组44例。术后随访30天,对比各组效果。结果造口十字组、重建十字组手术时长、切口愈合时间、术后拔管时间、术后住院时间均短于造口传统组、重建传统组,术中出血量少于造口传统组、重建传统组,差异有统计学意义(P<0.05)。造口十字组、重建十字组术后1、2、3天时数字评价量表(NRS)评分均低于造口传统组、重建传统组,差异有统计学意义(P<0.05)。造口十字组、重建十字组术后切口瘢痕色泽、厚度、血管、柔软度以及总分低于造口传统组、重建传统组,差异有统计学意义(P<0.05)。重建十字组术后并发症发生率为6.82%,低于重建传统组的24.32%,差异有统计学意义(P<0.05)。造口传统组与造口十字组并发症总发生率比较差异无统计学意义(P>0.05)。结论十字缝合法用于腹会阴联合切除术和肠造口关闭术中切口重建,兼具通畅引流和减张缝合的特点,可降低术后并发症发生率。Objective To analyze the effect and safety of“cross”suture in the reconstruction of perineal incision and closure of enterostomy for rectal cancer.Methods A total of 107 patients with perineal incision reconstruction during combined abdominal perineal resection and abdominal incision reconstruction during enterostomy closure treated in our hospital from January 2019 to January 2022 were selected.They were divided into traditional stoma group(12 cases),stoma“cross”group(14 cases),traditional reconstruction group(37 cases)and reconstruction“cross”group(44 cases).Follow up for 30 days after operation to compare the effects of each group.Results The operation time,incision healing time,postoperative extubation time,and postoperative hospital stay in the ostomy“cross”group and the reconstruction“cross”group were shorter than those in the traditional ostomy group and the reconstruction traditional group,and the intraoperative blood loss was less than that in the traditional ostomy group and the reconstruction traditional group(P<0.05).The NRS score of the“cross group”and the reconstruction“cross group”1,2 and 3 days after surgery was lower than that of the traditional group and the traditional reconstruction group(P<0.05).The color,thickness,blood vessels,softness and total score of postoperative incision in the“cross group”and the reconstruction“cross group”were lower than those in the traditional group and the traditional reconstruction group(P<0.05).The incidence of postoperative complications in the reconstruction“cross”group was 6.82%,significantly lower than that in the traditional reconstruction group(24.32%)(P<0.05).There was no difference in the total incidence of complications between the traditional stoma group and the stoma“cross”group(P>0.05).Conclusion“Cross”suture can be used for incision reconstruction during combined abdominal perineal resection and enterostomy closure.It has the characteristics of“unobstructed drainage”and“reduced tension suture”

关 键 词：直肠癌 会阴切口重建 肠造口关闭术 十字缝合法 安全性 

分 类 号：R735.37[医药卫生—肿瘤]