体表固定装置用于微创食管癌切除术患者空肠造瘘管固定中的临床研究  

Clinical Study of Body Surface Fixation Device for Jejunostomy Tube Fixation in Patients with Minimally Invasive Resection of Esophageal Cancer

作　　者：王萍 陈婷 龚太乾 张静文 郑青 计书菌 范博士 WANG Ping;CHEN Ting;GONG Taiqian(Department of General Surgery,the Second Medical Center,Chinese PLA General Hospital,Beijing 100039)

机构地区：[1]中国人民解放军总医院第二医学中心综合外科,北京100039 [2]南方医科大学护理学院,广东广州510440 [3]中国人民解放军总医院第六医学中心胸外科,北京100048

出　　处：《医学临床研究》2024年第11期1637-1639,1643,共4页Journal of Clinical Research

基　　金：国家自然科学基金资助项目(81902433);首都临床特色应用研究与成果推广项目(Z161100000516185)。

摘　　要：【目的】探讨空肠造瘘管不同固定方式对微创食管癌切除术后留置空肠造瘘管的患者术后恢复的影响。【方法】选取2021年9月至2023年2月中国人民解放军总医院收治的108例行微创食管癌根治术(MIE)并留置空肠造瘘管患者,根据随机数字表法将其分为观察组(n=56)和对照组(n=52)。观察组使用中国人民解放军总医院研发的体表固定装置固定造瘘管,对照组使用优韧宁敷料固定造瘘管,比较两组患者术后14 d(T 1)、30 d(T 2)、60 d(T 3)、90 d(T 4)4个时间段的非计划拔管情况,与固定装置有关的造瘘管的并发症发生情况及术后恢复情况[首次排气时间、首次排便时间和日常生活能力量表(ADL)]。【结果】观察组患者术后T 2、T 3、T 4时间段内非计划拔管率均低于对照组,差异有统计学意义(P<0.05)。两组患者置管期间造瘘管移位、造瘘管渗漏以及管周感染的发生率低于对照组,观察组患者并发症总发生率明显低于对照组,差异均有统计学意义(P<0.05)。观察组患者术后首次排气时间、首次排便时间均短于对照组,观察组术后7 d和14 d的ADL评分高于对照组,差异有统计学意义(P<0.05)。【结论】造瘘管体表固定装置可增强空肠造瘘管的固定作用,降低非计划拔管率,提高患者的日常生活能力,降低因空肠造瘘管固定不良所引起的并发症发生率。【Objective】To investigate the effect of different fixation methods of jejunostomy tube on postoperative recovery of patients with jejunostomy tube after minimally invasive resection of esophageal cancer.【Methods】A total of 108 patients who underwent minimally invasive esophagectomy(MIE)while indwelling jejunostomy tube were selected from the Chinese PLA General Hospital from September 2021 to February 2023,and were divided into observation group(n=56)and control group(n=52)according to random number table method.The observation team used a body surface fixation device developed by the General Hospital,Chinese People's Liberation Army to fix the fistula tube.The control group was fixed with Adhensive Dressing.The unplanned extubation at 14 days(T 1),30 days(T 2),60 days(T 3)and 90 days(T 4)after surgery were compared between the two groups,as well as the occurrence of complications related to fixed devices and postoperative recovery[first exhaust,defecation time and ability of daily living scale(ADL)].【Results】The rate of unplanned extubation in T 2,T 3 and T 4 after operation in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The incidence of fistula displacement,fistula leakage and peritubular infection during catheterization in two groups was lower than that in control group,and the total incidence of complications in the observation group was significantly lower than that in the control group,with statistical significance(P<0.05).The first postoperative exhaust time and defecation time of the observation group were shorter than those of the control group,and the ADL scores of the observation group were higher than those of the control group at 7 and 14 days after the operation,with statistical significance(P<0.05).【Conclusion】The body surface fixation device of jejunostomy tube can enhance the fixation function of jejunostomy tube,reduce the rate of unplanned extubation,improve the patients'ability of daily living,and reduce th

关 键 词：食管肿瘤/外科学 外固定器 空肠造口术 

分 类 号：R735.1[医药卫生—肿瘤]