预防性回肠造口对防止癌性肠梗阻患者术后吻合口瘘的临床价值分析  

Clinical value of prophylactic ileostomy in preventing postoperative anastomotic fistula in patients with malignant bowel obstruction

作　　者：陈明[1] CHEN Ming(Liyang Traditional Chinese Medicine Hospital,Liyang 213300,China)

机构地区：[1]江苏省溧阳市中医医院,213300

出　　处：《中国现代药物应用》2023年第18期52-55,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨预防性回肠造口对防止癌性肠梗阻患者术后吻合口瘘的临床价值。方法78例癌性(乙状结肠癌及直肠癌)肠梗阻患者,根据随机数字表法分为对照组(56例)和观察组(22例)。对照组采用一期大肠癌根治性手术治疗,观察组在对照组基础上联合预防性回肠造口治疗。比较两组手术指标、白蛋白水平、生活质量评分及术后并发症发生情况。结果两组手术时间、肿瘤距肛门距离比较差异无统计学意义(P>0.05)。观察组住院时间(23.19±3.24)d短于对照组的(32.56±4.61)d,治疗费用(4.96±0.73)万元少于对照组的(6.83±0.81)万元,差异有统计学意义(P<0.05)。手术前,两组白蛋白水平比较差异无统计学意义(P>0.05);手术后,两组白蛋白水平均高于本组手术前,且观察组白蛋白(48.24±7.39)g/L高于对照组的(44.12±6.21)g/L,差异有统计学意义(P<0.05)。手术后,两组生理、心理、环境、独立性、社会关系、精神支柱评分均明显高于手术前,且观察组生理、心理、环境、独立性、社会关系、精神支柱评分分别为(17.38±2.62)、(17.45±2.55)、(18.25±1.75)、(18.12±1.83)、(17.86±2.74)、(18.33±1.67)分,均明显高于对照组的(15.29±2.55)、(15.21±2.49)、(14.37±2.52)、(14.79±2.50)、(14.32±2.48)、(15.05±2.50)分,差异有统计学意义(P<0.05)。观察组并发症发生率9.09%低于对照组的30.36%,差异有统计学意义(P<0.05)。结论预防性回肠造口能防止癌性肠梗阻患者术后发生吻合口瘘,可减轻手术创伤,提高患者生活质量,值得推广应用。Objective To discuss the clinical value of prophylactic ileostomy in preventing postoperative anastomotic fistula in patients with malignant bowel obstruction.Methods A total of 78 patients with malignant bowel obstruction(caused by sigmoid colon cancer and rectal cancer)were divided into control group(56 cases)and observation group(22 cases)according to the random numerical table.The control group was treated with primary radical surgery for colorectal cancer,and the observation group was combined with prophylactic ileostomy on the basis of the control group.The operative indexes,albumin level,quality of life score and incidence of postoperative complications were compared between the two groups.Results There was no statistically significant difference in operative time and distance of tumor from anal verge between the two groups(P>0.05).The hospitalization time of(23.19±3.24)d in the observation group was shorter than that of(32.56±4.61)d in the control group;the treatment cost of(4.96±0.73)ten thousand yuan in the observation group was less than that of(6.83±0.81)ten thousand yuan in the control group;the differences were statistically significant(P<0.05).Before surgery,there was no statistically significant difference in albumin between the two groups(P>0.05).After surgery,the albumin in both groups was higher than that before surgery in this group,and the albumin of(48.24±7.39)g/L in the observation group was higher than that of(44.12±6.21)g/L in the control group.The differences were statistically significant(P<0.05).After surgery,the scores of physiology,psychology,environment,independence,social relationship and spiritual support in both groups were significantly improved;the scores of physiology,psychology,environment,independence,social relationship and spiritual support in the observation group were(17.38±2.62),(17.45±2.55),(18.25±1.75),(18.12±1.83),(17.86±2.74)and(18.33±1.67)points,which were significantly higher than those of(15.29±2.55),(15.21±2.49),(14.37±2.52),(14.79±2.50),(14.32±

关 键 词：癌性肠梗阻 吻合口瘘 预防性回肠造口 生活质量 并发症 

分 类 号：R735.37[医药卫生—肿瘤]