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Received:August 27, 2020 Published Online:May 20, 2021
Received:August 27, 2020 Published Online:May 20, 2021
中文摘要: 目的 探讨左半结肠癌及直肠癌肠梗阻急诊手术中应用肠道灌洗套件进行逆行冲洗对术后的影响。方法 回顾性分析2016年9月至2019年9月收治的78例左半结肠癌及直肠癌合并急性肠梗阻患者术中肠道灌洗套件的应用和治疗效果。其中行Ⅰ期切除吻合的39例患者为研究组,Ⅰ期失功能性造口、Ⅱ期吻合的39例为对照组,两组术中均采用肠道灌洗套件进行逆行冲洗。结果 两组均顺利完成手术,两组并发症发生率差异无统计学意义(P>0.05),无术中和住院期间死亡病例。研究组胃肠道功能恢复时间[(4.1±0.9)d vs (5.9±1.3)d,P<0.01]、手术时间[(3.4±0.7)h vs (5.3±1.0)h,P<0.01]、住院时间[(16.3±2.1)d vs (24.5±2.0)d,P<0.01]短于对照组。结论 对左半结肠癌及直肠癌合并肠梗阻,术中用肠道灌洗套件肠道逆行冲洗使得原需二次手术者采用Ⅰ期切除吻合成为安全可行的手术方式,可缩短患者手术时间、胃肠道功能恢复时间、住院时间。
Abstract:Objective To investigate the effect of retrograde perfusion with intestinal lavage kit in emergency operation of intestinal obstruction in patients with left hemicolon carcinoma and rectal carcinoma.Methods A retrospective analysis was performed on 78 patients with left hemicolon carcinoma and rectal cancer complicated with acute intestinal obstruction from September 2016 to September 2019.There were 39 patients treated with one-stage resection and anastomosis in experimental group and 39 patients treated with one-stage dysfunctional colostomy and two-stage anastomosis in control group.The retrograde perfusion by intestinal lavage kit was conducted during surgery in both groups.Results The operations were successfully completed in both groups.Anastomotic leakage occurred in 1 case in experimental group and 1 case in control group.There were 2 cases of incision infection in experimental group and 1 case in control group.There was no statistical difference in the incidence of complications between two groups (P>0.05).No death occurred during the operation and hospitalization.The recovery time of gastrointestinal function in experimental group was significantly shorter than that in control group[(4.1±0.9)d vs(5.9±1.3)d,P<0.01 ].Compared with control group,the operation time [(3.4±0.7) h vs(5.3±1.0) h,P<0.01 ] and hospital stay [(16.3±2.1) d vs(24.5±2.0) d,P<0.01 ] decreased significantly in experimental group.Conclusions In the treatment of left hemicolon carcinoma and rectal cancer complicated with intestinal obstruction,retrograde perfusion with intestinal lavage kit during primary resection and anastomosis is a safe and feasible surgical method for patients who need secondary operation.At the same time,it can shorten the patient′s operation time,gastrointestinal function recovery time,and hospital stay.
keywords: Left hemicolon carcinoma Rectal carcinoma Intestinal obstruction Retrograde perfusion Intestinal lavage kit Primary resection and anastomosis One-stage dysfunctional colostomy Two-stage anastomosis
文章编号: 中图分类号:R735.3 文献标志码:B
基金项目:
Author Name | Affiliation |
CHEN Zhi-nan,HOU Li-min,MA Jing | Emergency Center,the First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150000,China |
Author Name | Affiliation |
CHEN Zhi-nan,HOU Li-min,MA Jing | Emergency Center,the First Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150000,China |
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