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自闭性保护性回肠造口在高危结直肠吻合手术中的临床研究 被引量:6

Clinical study of automatic closing protective ileostomy in high risk colorectal anastomosis
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摘要 目的探讨自闭性保护性回肠造口在高危结直肠吻合手术中的价值。方法回顾性分析2014年7月至2017年12月广西桂东人民医院收治的需行保护性造口的高危结直肠吻合手术病例59例,分成2组,行自闭性保护性回肠造口术36例为观察组,行传统襻式回肠造口术23例为对照组,比较2组病人术后吻合口瘘发生率、肠道再通时间、住院时间、并发症、造口自闭率、二次手术、经济性等指标。结果 2组病人均无吻合口瘘发生。观察组肠造口对远端吻合口的保护期限平均为27.3 d,观察组肠造口100%能自行闭合,无二期手术病例,观察组在肠道再通时间、住院时间、总并发症发生率、经济性等明显优于对照组,差异均有统计学意义(均P<0.05)。结论自闭性保护性回肠造口及袢式回肠造口对高危结直肠吻合口均有良好的保护作用,自闭性保护性回肠造口具有操作简单、并发症少、住院时间短、避免了二期造口回纳手术、住院费用低等优点。值得在各级医院推广应用。 Objective To investigate the clinical value of automatic closing protective ileostomy in high-risk colorectal anastomosis.Methods A retrospective analysis was performed on 59 cases of high-risk colorectal anastomosis from July 2014 to December 2017 in our department,and patients were randomly divided into 2 groups:observation group,including 36 cases given automatic closing protective ileostomy,and control group,including 23 cases undergoing conventional loop ileostomy.The incidence of anastomotic leakage,intestinal recanalization time,hospitalization time,complications,ostomy,secondary surgery,expenses and other indicators were compared between two groups.Results No anastomotic fistula occurred in two groups.The average duration of protection for the distal anastomotic stoma in the observation group was 27.3 days.The stomas of 100% of the patients in the observation group could be closed on their own.There were no reoperation cases in the observation group,and the time of intestinal recanalization,the time of hospitalization,the incidence of total complications and the expenses were significantly decreased in the observation group as compared with those in the control group(P〈0.05 for all).Conclusions The automatic closing protective ileostomy and loop ileostomy have positive protective effects on high risk colorectal anastomosis.The automatic closing protective ileostomy has the advantages of simple operation,less complications,shorter hospital stay,and less hospitalization expenses,and the two-stage stoma recovery operation can be avoided.
作者 汪祖来 黄顺荣 邓褫夺 孙伟峰 虞敏 钟雪梅 李冬梅 Wang Zu-lai;Huang Shunrong;Deng Chiduo;Sun Wei feng;Yu Min;Zhong Xuemei;Li Dongmei(The People's Hospital of Guangxi,Guidong 543001,China)
出处 《腹部外科》 2018年第4期257-260,265,共5页 Journal of Abdominal Surgery
关键词 结直肠手术 保护性造口术 吻合口瘘 Colorectal surgery Protective stoma Anastomotic fistula
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