经回肠双襻造口远端灌肠对术前肠镜及术后肠功能恢复的影响  

Effect of anterograde lavage via ileal double-loop stoma on preoperative colonoscopy and postoperative recovery of bowel function

作　　者：黄书荣 HUANG Shurong(Department of Gastrointestinal Surgery,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,Fujian,China)

机构地区：[1]福建医科大学附属泉州第一医院胃肠外科,福建泉州362000

出　　处：《中国现代医生》2024年第4期28-30,42,共4页China Modern Doctor

摘　　要：目的探讨经回肠双襻造口远端灌肠对术前肠镜检查及术后肠道功能的影响。方法选取2019年1月至2021年12月于福建医科大学附属泉州第一医院行腹腔镜直肠前切除术+预防性回肠双襻造口的患者191例,根据灌肠方式不同将其分为顺行组(n=97)和逆行组(n=94);顺行组患者经临时性回肠双襻造口远端灌肠,逆行组患者经肛门灌肠。比较两组患者的肠镜合格率、肠黏膜外力损伤率、排气时间、排便时间、进食流质时间、总住院时间、住院总费用和满意度。结果顺行组患者的术前肠镜合格率显著高于逆行组,肠黏膜外力损伤率显著低于逆行组(P<0.05);顺行组患者的术后排气时间、进食流质时间、住院总时间均显著短于逆行组(P<0.05);顺行组患者的住院总费用显著低于逆行组(P<0.05);顺行组患者的满意度显著高于逆行组(89.69%vs.52.13%,Z=–7.165,P<0.001)。结论经回肠双襻造口远端灌肠可提高术前肠镜检查合格率,有利于术后肠功能恢复,减轻患者痛苦,患者的满意度及舒适性更高,值得临床推广应用。Objective To investigate the effect of anterograde lavage via ileal double-loop stoma on preoperative colonoscopy and postoperative bowel function.Methods A total of 191 patients who underwent laparoscopic anterior rectal resection plus prophylactic double-loop ileal stomy in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to December 2021 were selected and divided into anterograde group(n=97)and retrograde group(n=94)according to different lavage methods.Patients in anterograde group underwent temporary double-loop ileal stomy with distal lavage.Patients in retrograde group underwent anal lavage.The qualified rate of colonoscopy,external damage rate of intestinal mucosa,exhaust time,defecation time,fluid intake time,total hospitalization time,total hospitalization cost and satisfaction of two groups of patients were compared.Results The qualified rate of preoperative colonoscopy in anterograde group was significantly higher than that in retrograde group,and the external damage rate of intestinal mucosa was significantly lower than that in retrograde group(P<0.05).The postoperative exhaust time,fluid intake time and total hospitalization time in anterograde group were significantly shorter than those in retrograde group(P<0.05).The total hospitalization cost in anterograde group was significantly lower than that in retrograde group(P<0.05).The satisfaction of patients in anterograde group was significantly higher than that in retrograde group(89.69%vs.52.13%,Z=–7.165,P<0.001).Conclusion Anterograde lavage via ileal double-loop stoma can improve the qualified rate of preoperative colonoscopy,is conducive to postoperative intestinal function recovery,reduce patients’pain,and improve patients’satisfaction and comfort,which is worthy of clinical application.

关 键 词：直肠癌 回肠双襻造口 顺行肠道准备 逆行肠道准备 舒适化医疗 

分 类 号：R656[医药卫生—外科学]