B型缝合法回肠造口术的临床应用  

Clinical application of ileostomy with type B suture

作　　者：孙龙和 周家杰 王伟[4] 张琪[4] 钱春华[2] 赵帅 李瑞奇 孙倩男 王道荣[4,5,6] Sun Longhe;Zhou Jiajie;Wang Wei;Zhang Qi;Qian Chunhua;Zhao Shuai;Li Ruiqi;Sun Qiannan;Wang Daorong(Department of General Surgery,Clinical Medical College,Yangzhou University,Yangzhou 225001,China;Department of General Surgery,Taizhou Fourth People's Hospital,Taizhou 225300,China;Department of General Surgery,Clinical Teaching Hospital,Nanjing Medical University,Su Bei People's Hospital,Yangzhou 225001,China;Department of General Surgery,Su Bei People's Hospital of Jiangsu Province,Yangzhou 225001,China;Yangzhou University-Yangzhou Municipal General Surgery Institute,Yangzhou 225001,China;Key Laboratory of Digestive Disease/Metabolic Disease Basic and Clinical Transformation,Yangzhou 225001,China)

机构地区：[1]扬州大学临床医学院普外科,扬州225001 [2]泰州市第四人民医院普外科,泰州225300 [3]南京大学医学院临床教学医院苏北人民医院普外科,扬州225001 [4]江苏省苏北人民医院普外科,扬州225001 [5]扬州大学-扬州市普通外科研究所,扬州225001 [6]扬州市消化病/代谢病基础与临床转化重点实验室,扬州225001

出　　处：《中华普通外科杂志》2024年第3期211-216,共6页Chinese Journal of General Surgery

基　　金：消化病/代谢病基础与临床转化重点实验室项目(YZ2020159);2023年泰州市海陵区科技发展计划(社会发展)项目。

摘　　要：目的评价B型缝合法回肠造口术的安全性与有效性。方法回顾性分析204例腹腔镜低位直肠前切除术联合保护性回肠造口患者的临床资料,根据造口方式不同分为B型缝合法造口组(n=67)和传统法造口组(n=137)。结果与传统造口组相比,B型缝合法造口组在总手术时间[(164±26)min比(172±24)min,t=2.229,P=0.027]、造口时间[(12.7±2.3)min比(14.8±2.2)min,t=-6.565,P<0.001]、出血量[(57±20)ml比(69±31)ml,t=-2.797,P=0.006]、术后住院时间[(10.2±1.9)d比(11.8±2.3)d,t=-4.851,P<0.001]、取标本切口感染率(0比5.1%,P=0.047)、术后躯体疼痛评分[82(79~84)比78(76~80),Z=-5.805,P<0.001]、造口还纳手术时间[(46±11)min比(51±12)min,t=-2.540,P=0.012]方面差异均有统计学意义(均P<0.05)。结论B型缝合法回肠造口术用于腹腔镜低位直肠癌预防性造口是安全可行的。Objective To evaluate safety and efficacy of B-type suture method ileostomy.Methods Clinical data from 204 patients undergoing laparoscopic low anterior resection combined with protective ileostomy was analysed.Patients were divided into B-type suture ileostomy group(n=67)and traditional ileostomy group(n=137).Results compared with traditional ileostomy group,B-type suture ileostomy group showed statistically significant differences in total operation time[(164±26)min vs.(172±24)min,t=2.229,P=0.027],ileostomy time[(12.7±2.3)min vs.(14.8±2.2)min,t=-6.565,P<0.001],blood loss[(57±20)ml vs.(69±31)ml,t=-2.797,P=0.006],postoperative hospital stay[(10.2±1.9)d vs.(11.8±2.3)d,t=-4.851,P<0.001],specimen incision infection rate(0 vs.5.1%,P=0.047),postoperative body pain[82(79-84)vs.78(76-80),Z=-5.805,P<0.001],and ileostomy incorporation time[(46±11)min vs.(51±12)min,t=-2.540,P=0.012].Conclusion B-type suture ileostomy for prophylactic ileostomy in laparoscopic low anterior resection for rectal cancer is safe and feasible.

关 键 词：直肠肿瘤 回肠造口术 手术后并发症 腹腔镜 

分 类 号：R735.37[医药卫生—肿瘤]