摘要
目的:探讨食管癌患者器械吻合和手工吻合行早期进食的安全性和有效性。方法:回顾性分析2017年1月-2018年3月于本院进行手术治疗的94例食管癌患者的临床资料。根据手术方式的不同将其分为器械吻合组49例与手工吻合组45例。器械吻合组手术中给予器械吻合,手工吻合组手术中给予手工吻合。观察比较两组临床指标、营养指标及术后并发症发生情况。结果:器械吻合组手术时间、吻合时间、留置胸管时间、恢复进食时间及住院时间均明显短于手工吻合组,术中出血量少于手工吻合组,差异均有统计学意义(P<0.05)。术后1、7、14 d,两组血清白蛋白、前白蛋白及血红蛋白水平均呈上升趋势,差异均有统计学意义(P<0.05)。术后7、14 d,器械吻合组血清白蛋白、前白蛋白水平依次升高,且血清白蛋白、前白蛋白及血红蛋白水平均明显高于手工吻合组,差异均有统计学意义(P<0.05)。器械吻合组术后并发症发生率为14.29%,明显低于手工吻合组的37.78%,差异有统计学意义(P<0.05)。结论:对食管癌患者手术中给予器械吻合行早期进食安全可行,临床效果明显,可有效改善术后营养状况,且术后并发症发生率更低,值得推广应用。
Objective:To discuss the safety and efficacy of early stage feeding between instrument anastomosis and manual anastomose of esophageal cancer patients.Method:The clinical data of 94 patients with esophageal cancer who underwent surgical treatment in our hospital from January 2017 to March 2018 were retrospectively analyzed.According to different surgical methods,the patients were divided into instrument anastomosis group 49 cases and manual anastomosis group 45 cases.Instrument anastomosis was given during operation in instrument anastomosis group,manual anastomosis was performed in the manual anastomosis group.Clinical indicators,nutritional indicators and postoperative complications were observed and compared between the two groups.Result:The operative time,anastomosis time,indwelling time of thoracic duct,recovery time of feeding and hospitalization time of patients in the instrument anastomosis group were significantly shorter than those in the manual anastomosis group,the intraoperative blood loss was less than that in the manual anastomosis group,with statistically significant differences(P<0.05).At 1,7 and 14 d after surgery,serum albumin,prealbumin and hemoglobin levels of two groups all showed an upward trend,the differences were statistically significant(P<0.05).At 7 and 14 d after surgery,serum albumin and prealbumin levels in the instrument anastomosis group were successively increased,and serum albumin,prealbumin and hemoglobin levels were significantly higher than those in the manual anastomosis group,with statistically significant differences(P<0.05).The incidence of postoperative complications in the instrument anastomosis group was 14.29%,it was significantly lower than 37.78%in the manual anastomosis group,the difference was statistically significant(P<0.05).Conclusion:It is safe and feasible to give early stage feeding for patients with esophageal cancer by instrument anastomosis during surgery,with obvious clinical effect,which can effectively improve postoperative nutritional status,and lower
作者
王海
WANG Hai(The First People’s Hospital of Xianning,Xianning 437000,China)
出处
《中国医学创新》
CAS
2020年第24期44-47,共4页
Medical Innovation of China
关键词
食管癌
器械吻合
手工吻合
早期进食
Esophageal cancer
Instrument anastomosis
Manual anastomosis
Early stage feeding
