摘要
目的:探讨术中肠灌洗加预防性回肠造瘘对结直肠癌并肠梗阻I期切除吻合患者疗效及胃肠功能的影响。方法:选取85例行结直肠癌并发肠梗阻Ⅰ期切除吻合术患者为研究对象,根据治疗方式不同分为研究组(n=42)和对照组(n=43)。研究组在术中行灌肠洗加预防性回肠造瘘;对照组仅在术中肠灌洗未行预防性回肠造瘘。比较两组患者术中出血量、手术时间、住院时间、首次排气时间及术前胃肠功能、肠内营养及前白蛋白量、术前及术后的生活质量、术后并发症发生情况。结果:研究组患者手术时间长于对照组(P<0.05);住院时间及术后首次排气时间短于照组(P<0.05);术中出血量高于对照组,但差异无统计学意义(P>0.05)。术后,两组患者MTL及GAS水平均降低(P<0.05),且研究组低于对照组(P<0.05)。术后5 d,两组患者进食量总量和前白蛋白水平均升高(P<0.05),且研究组高于对照组(P<0.05)。术后,两组患者功能维度评分及症状维度评分均较术前降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。研究组患者术后吻合瘘发生率及并发症总发生率低于对照组(P<0.05)。结论:术中肠灌洗加预防性回肠造瘘对结直肠癌并肠梗阻I期切除吻合患者的疗效好,可加快患者的恢复进程,改善其胃肠功能及生活质量,降低患者术后并发症发生率。
Objective:To explore the effect of intraoperative intestinal lavage and preventive ileostomy on stage Ⅰ resection and anastomosis of colorectal cancer and intestinal obstruction and the impact on gastrointestinal function.Methods:A total of 85 patients who received stage Ⅰ resection and anastomosis for colorectal cancer complicated with intestinal obstruction were prospectively included as the research group.The patients who received intraoperative enema washing and preventive ileostomy were taken as the research group(n=42),and the patients who only received intraoperative intestinal lavage and did not receive preventive ileostomy were taken as the control group(n=43).The intraoperative bleeding volume, operation time, hospital stay, and first exhaust time, preoperative gastrointestinal function, enteral nutrition and prealbumin, preoperative and postoperative quality of life and postoperative complications were compared between the two groups.Results:The operation time of the study group was higher than that of the control group, and the hospitalization time and the first postoperative exhaust time were significantly shorter than that of the control group(P<0.05).The blood loss in the study group was higher than that in the control group, but the difference was not statistically significant(P>0.05).After operation, the levels of MTL and GAS in both groups were significantly reduced(P<0.05),and the study group were lower than the control group(P<0.05).5 days after operation, the total food intake and prealbumin level of the two groups increased significantly(P<0.05),and the study group were higher than the control group(P<0.05).After operation, the scores of functional dimension and symptom dimension in the two groups were lower than those before operation(P<0.05),but there was no significant difference between the study group and the control group(P>0.05).The incidence of postoperative anastomotic leakage and total incidence of complications in the study group were lower than those in the control group(P<0.
作者
覃建论
陆华勇
张汉松
QIN Jian-lun;LU Hua-yong;ZHANG Han-song(Department of General Surgery,the Third People's Hospital of Hechi,Hechi 547000,Guangxi,China)
出处
《川北医学院学报》
CAS
2022年第6期742-745,749,共5页
Journal of North Sichuan Medical College
基金
广西河池市科技计划项目(AB193630)。
关键词
结直肠癌
肠梗阻
术中肠灌洗
预防性回肠造瘘
I期切除吻合术
胃肠功能
Colorectal cancer
Intestinal obstruction
Intraoperative intestinal lavage
Preventive ileostomy
Stage Ⅰ resection and anastomosis
Gastrointestinal function
