摘要
目的研究瘤体下缘距肛门不同距离对直肠癌双吻合术后吻合口漏预防效果的影响。方法选取我院肛肠外科2012年4月至2015年3月期间收治的72例中低位直肠癌患者,根据患者瘤体下缘与肛门口距离不同分为对照组（距离〈7 cm）和观察组（距离≥7 cm）各36例,选取对象时尽量确保两组患者一般资料均衡性,由同组手术人员对两组患者行双吻合术治疗。比较两组手术时间、术中出血量、住院时间等手术基本指标,观察两组保肛率、术后吻合口漏发生情况,比较术后肛门排便功能。结果观察组手术时间、术中出血量、住院时间分别较对照组低,均差异显著（P〈0.05）;对照组、观察组保肛率分别为91.67%、94.44%,保肛效果较好且二者相较无显著差异（P〉0.05）;两组于术后5-10 d内出现吻合口漏症状,其中观察组吻合口漏发生率较对照组低,差异显著（P〈0.05）,通过扩肛、清洗引流后逐步愈合;观察组术后3个月肛门排便功能（Ⅰ级12例,Ⅱ级18例,Ⅲ级5例,Ⅳ级1例,Ⅴ级0例）优于对照组（Ⅰ级9例,Ⅱ级13例,Ⅲ级10例,Ⅳ级3例,Ⅴ级0例）,差异显著（P〈0.05）。结论吻合口漏是直肠癌双吻合术的常见并发症,患者瘤体下缘与肛门的距离是影响吻合口漏发生的重要因素,当二者距离较近（〈7cm）时,提示发生的吻合口漏风险较大,应引起临床重视并采取相应措施。
Objective To study the effects of different distance between the anal verge and the lower margin of the tumor on prophylactic effect of anastomotic leakage after double stapling technique for rectal cancer. Methods 72 cases of patients with mid-low rectal cancer treated in the department of anorectal surgery of our hospital from April 2012 to March 2015 were selected, according to the different distance between the anal verge and the lower margin of the tumor, they were divided into the control group（distance7cm） and the observation group（distance≥7cm）（each 36 cases）, selection should ensure patients＇ general information equilibrium of two groups as far as possible, the two groups received double stapling technique by the same surgical staffs. Operation time, intraoperative blood loss, hospitalization time and other surgical basic indexes in the two groups were compared,reserving anus rates, occurrence of postoperative anastomotic leakage in the two groups were observed, postoperative anus defecate function were compared. Results Operation time, intraoperative blood loss, hospitalization time of the the observation group were significantly lower than the control group（P0.05）; reserving anus rates of the control group and the observation group were 91.67% and 94.44% respectively, the two groups had a good effect of reserving anus and they had no significant difference（P〉0.05）; anastomotic leakage occurred in the two groups 5-10 d after the operation, the incidence of anastomotic leakage in the observation group was significantly lower than the control group（P〈0.05）, anastomotic leakage healed gradually after anal dilation, cleaning and drainage; anus defecate function of the observation group 3 months after the operation（grade Ⅰ, 12 cases; grade Ⅱ, 18 cases; grade Ⅲ, 5 cases; grade Ⅳ, 3 case; grade Ⅴ, 0 case） were significantly better than the control group（grade Ⅰ, 9 cases; grade Ⅱ, 13 cases; grade Ⅲ, 10 cases; grade Ⅳ, 3 cases; grade Ⅴ, 0 case）（P0.05�
出处
《结直肠肛门外科》
2016年第2期160-163,共4页
Journal of Colorectal & Anal Surgery
关键词
中低位直肠癌
瘤体距离
双吻合术
预防效果
Mid-low rectal cancer
Distance of tumor
Double stapling technique
Prophylactic effect
