摘要
目的探讨急性肠道梗阻Ⅰ期切除吻合术中结肠灌洗的临床效果和安全性。方法回顾性分析2012年1月~2015年12月广东省中医院肛肠科因急性肠梗阻入院的患者60例,按手术方式的不同分为结肠灌洗组和常规手术组,每组各30例,其中,结肠灌洗组患者行术中封闭式肠道顺行清洁灌洗且行Ⅰ期切除吻合术,常规手术组除无行术中灌洗外其他处理同结肠灌洗组。比较并记录两组患者吻合口瘘、术口感染、腹腔脓肿等并发症的发生情况,计算并发症发生率;观察并记录两组患者的手术时间、术后肛门恢复排气时间和住院时间。结果与常规手术组比较,结肠灌组患者的手术时间和肛门恢复排气时间稍长,但差异无统计学意义(P>0.05);结肠灌洗组患者在吻合口瘘、术中感染和腹腔脓肿等并发症等方面的发生率均明显降低,差异有统计学意义(P<0.05);结肠灌洗组患者的住院时间显著较短,差异有统计学意义(P<0.05)。结论采用"结肠灌洗+Ⅰ期切除吻合术"治疗急性肠梗阻患者临床效果理想,安全性较高,能够使患者在降低术后并发症发生率、缩短住院时间等方面获益,值得临床上进一步优化推广。
Objective To investigate the clinical effect and safety of colonic lavage in one-stage resection and anasto- mosis of acute intestinal obstruction. Methods From January 2012 to December 2015, in Department of Anoreetal Surgery in Guangdong Province Traditional Chinese Medical Hospital, 60 patiens with acute intestinal obstruction treated were selected and retrospectively analyzed. They were divided into colonic lavage group and convention operation group ac- cording to different operation methods, with 30 cases in each group. Patients in the colonic lavage group underwent closed intestinal antegrade cleansing irrigation and stage I resection and anastomosis. The convention operation group had no intraoperative lavage, and the other treatment was the same as the colonic lavage group. The incidence of anas- tomotie leakage, intraoperative infection, abdominal abscess and other complications were recorded and the complica- tion rate were calculated respectively. The operation time and the recovery time for anal exsufflation were observed and recorded. Results Compared with the conventional surgery group, the operation time and the recovery time for anal ex- sufflation in colonic lavage group were longer, the differences were not statistically significant （P 〉 0.05）; the incidence of anastomotic leakage, intraoperative infection, abdominal abscess and other complications decreased significantly in the colonic lavage group, the differences were statistically significant （P 〈 0.05）; hospitalization time of colonic lavage group were significantly shortened, the differences were statistically significant （P 〈 0.05）. Conclusion ＂Colonic lavage＋ I stage resection and anastomosis＂ in the treatment of acute intestinal obstruction with satisfactory clinical effect and high safety can reduce the incidence of postoperative com- plications, and shorten the hospitalization time, it is worthy of further promotion and optimization.
出处
《中国医药导报》
CAS
2017年第23期103-106,共4页
China Medical Herald
基金
广东省中医药局建设中医药强省科研课题(20151215)
关键词
肠梗阻
结肠灌洗
Ⅰ期切除吻合
临床观察
Intestinal obstruction
Colonic lavag
I stage resection and anastomosis
Clinical observation
