预防性回肠造口术在腹腔镜直肠癌根治术患者中的应用效果  

Applicantion of prophylactic ileostomy in patients undergoing laparoscopic radical resection of rectal cancer

作　　者：张玉 王露兵 Zhang Yu;Wang Lubing(Department of Colorectal and Anal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院结直肠肛门外科,郑州450000

出　　处：《中国实用医刊》2025年第1期65-68,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨预防性回肠造口术(PI)在腹腔镜直肠癌(RC)根治术患者中的应用效果。方法回顾性抽取2021年5月至2023年4月于郑州大学第一附属医院行腹腔镜根治术的RC患者60例,按照术后PI使用情况将其分为使用组(30例)和未使用组(30例)。比较两组围术期指标、术后恢复情况、炎症指标[超敏-C反应蛋白(hs-CRP)、白细胞计数(WBC)]、胃肠功能[胃动素(MTL)、胃泌素(GAS)]及并发症发生情况。结果使用组术后首次排气、下床活动、胃肠功能恢复时间、住院时间短于未使用组(P<0.05);术后3 d,使用组hs-CRP、WBC水平低于未使用组(P<0.05);术后7 d,使用组MTL、GAS水平高于未使用组(P<0.05)。使用组并发症发生率(6.67%,2/30)低于未使用组(26.67%,8/30),P<0.05。结论PI用于腹腔镜RC根治术患者可减轻机体炎症,促进患者排气和下床活动,改善胃肠功能,缩短住院时间,且能减少切口感染、吻合口瘘等并发症的发生,提升治疗安全性。ObjectiveTo investigate the application of prophylactic ileostomy(PI)in patients undergoing laparoscopic radical resection of rectal cancer(RC).MethodsSixty RC patients who underwent laparoscopic radical resection in the First Affiliated Hospital of Zhengzhou University from May 2021 to April 2023 were retrospectively selected.And they were divided into the use group(30 cases)and the unused group(30 cases)according to the performance of postoperative PI.The perioperative indexes,postoperative recovery,inflammatory markers including hypersensitivity C-reactive protein(hs-CRP)and white blood cell count(WBC),gastrointestinal function assessed by motilin(MTL)and gastrin(GAS),and the occurrence of complications were compared between the two groups.ResultsThe time of first postoperative gas,ambulatory activity,recovery time of gastrointestinal function,and hospital stay in the use group were shorter than those in the unused group(P<0.05).The 3-day postoperative levels of hs-CRP and WBC in the use group were lower than those in the unused group(P<0.05),and the 7-day postoperative levels of MTL and GAS in the use group were higher than those in the unused group(P<0.05).The incidence of complication of the use group(6.67%,2/30)was lower than that of the unused group(26.67%,8/30),P<0.05.ConclusionsThe application of PI in patients undergoing laparoscopic RC radical surgery can reduce body inflammation,promote exhaust gas and getting out of bed,improve gastrointestinal function,shorten hospital stay,reduce the incidences of incision infection and anastomotic fistula,and improve treatment safety.

关 键 词：直肠癌 腹腔镜直肠癌根治术 预防性回肠造口术 胃肠功能 

分 类 号：R735.37[医药卫生—肿瘤]