不同骶前冲洗引流装置在直肠癌术患者并发症中临床应用
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摘要
目的:对比自制会阴骶前冲洗引流器与单腔引流器在低位直肠癌术后骶前腔引流过程中的临床疗效。方法:选取2012年7月-2017年7月在本院就诊的82例直肠癌患者,遵循自愿的原则按入院时间随机分为对照组(单腔引流器)和观察组(自制会阴骶前冲洗引流器),每组各41例。对比两组引流管拔管时间、住院时间等术后恢复情况指标和术后吻合口瘘等并发症发生情况。结果:观察组引流管拔管时间和住院时间情况均明显优于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:低位直肠癌术后患者应用自制会阴骶前冲洗引流器进行骶前腔的间断冲洗引流,能缩短引流管拔管时间和患者住院时间,更有利于减少术后吻合口瘘等并发症的发生,有效提高患者术后生活质量。
Objective:To compare the clinical efficacy of self-made perineal presacral irrigation drainage device and single lumen drainage device in the anterior sacral drainage after low rectal cancer operation.Method:82 cases of low rectal cancer operation were selected in our hospital from July 2012 to July 2017 and randomly divided into observation group(self-made perineal presacral irrigation drainage device)and control group(single lumen drainage device),41 cases in each group.The postoperative recovery indexes such as extubation time and hospitalization time of the drainage tube and the postoperative anastomotic leakage were compared between the two groups.Result:The extubation time of the drainage tube and hospitalization time in the observation group were significantly better than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:In patients with low rectal cancer,the application of Self-made perineal presacral irrigation drainage device for intermittent lavage drainage of the anterior sacral can shorten extubation time of the drainage tube and hospitalization time,and it is more conducive to reduce complications such as postoperative anastomotic leakage,reducing hospitalization costs and effectively improving the quality of life after surgery.
Objective:To compare the clinical efficacy of self-made perineal presacral irrigation drainage device and single lumen drainage device in the anterior sacral drainage after low rectal cancer operation.Method:82 cases of low rectal cancer operation were selected in our hospital from July 2012 to July 2017 and randomly divided into observation group(self-made perineal presacral irrigation drainage device)and control group(single lumen drainage device),41 cases in each group.The postoperative recovery indexes such as extubation time and hospitalization time of the drainage tube and the postoperative anastomotic leakage were compared between the two groups.Result:The extubation time of the drainage tube and hospitalization time in the observation group were significantly better than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:In patients with low rectal cancer,the application of Self-made perineal presacral irrigation drainage device for intermittent lavage drainage of the anterior sacral can shorten extubation time of the drainage tube and hospitalization time,and it is more conducive to reduce complications such as postoperative anastomotic leakage,reducing hospitalization costs and effectively improving the quality of life after surgery.
引文
[1]杨俊奎.腹腔镜与开腹Miles术式治疗直肠癌的疗效对比[J].中国医药指南,2018,2(16):134-135.
[2]刘江,李彦卿,郑海军,等.骶前双套管引流联合三腔管肠腔内引流预防低位直肠癌吻合口瘘的效果研究[J].现代中西医结合杂志,2017,26(16):1770.
[3]杨程.骶前双管引流在治疗直肠癌术后吻合口瘘中应用[J].中国医学创新,2011,8(12):60-61.
[4]付晓云.自制冲洗引流器在直肠癌Miles术后的应用[J].中国临床研究,2012,25(6):583-584.
[5]佘加和,黄项武,董志勇.自制双套管持续冲洗治疗腹腔镜低位直肠癌根治术后吻合瘘[J].河北医科大学学报,2015,36(4);408-411.
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[7]杨敏,杨智蓉.ELOCK引流管固定器在妇科恶性肿瘤患者腹腔镜术后的应用效果[J].当代护士(下旬刊),2017(11):58-61.
[8]洪澜,贺国丽,杨舒盈.腹壁切口缝合中皮下放置引流管在肥胖妇科肿瘤患者手术中的临床应用[J].实用妇产科杂志,2014,11(30):865-868.
[9]吕光东,杨高禄,郭振敏.中下段直肠癌术后双管联合肛管引流的应用[J].中国现在普通外科进展,2016,19(7):558.
[10]刘铁,孙军席,王海霞,等.持续负压引流配合间断冲洗对腹腔镜肛提肌外腹会阴联合切除术后手术部位感染的影响[J].中华胃肠外科杂志,2018,21(6):688-689.
[11]李世邦,刘牧林,孔令尚,等.我国直肠癌前切除术后发生吻合口瘘危险因素的Meta分析[J/OL].中华普外科学文献电子版,2013,7(3):52-56.
[12]田少林,高友兵.经肛门吻合口瘘引流治疗直肠癌保肛术后吻合口瘘临床疗效观察[J].中国实用外科杂志,2015.35(5):549-551,554.
[13]李卫冬,贾林.结直肠癌的社区筛查及早期诊治[J/OL].中华临床医师杂志(电子版),2015,9(5):13-15.
[14]羊涛,张嘉越,冷津立,等.肠腔内外双套管负压引流在左半结肠穿孔行一期修补术中的应用[J].中华普通外科杂志,2014,29(11):872-873.
[15]王维新,成德文,祁卫东.预置改良双套管治疗贲门癌、直肠癌术后吻合口瘘的临床研究[J].医学理论与实践,2013,26(24):3270-3271.
[16]张嘉越,黄永鸿,庞飞雄,等.肠腔内外双套管负压引流在左半结肠癌并急性梗阻一期切除吻合中的应用[J].中国普外基础与临床杂志,2015,22(3):307-311.
[17]欧明明,韩培彦,黄晓峰.一次性闭合高负压引流瓶在根治性颈淋巴结清扫术后应用的研究[J].临床和实验医学杂志,2017,16(12):1232-1234.
[18]李文霞,刘丹,黄淑俊.真空高负压引流与潘氏管双管引流在乳腺癌手术中的应用效果[J].中国医药导报,2015,12(35):99-102.
[19]刘江,李彦卿,郑海军,等.骶前双套管引流联合三腔管肠腔内引流预防低位直肠癌吻合口瘘的效果研究[J].现代中西医结合杂志,2017,26(16):1768-1770.
[2]刘江,李彦卿,郑海军,等.骶前双套管引流联合三腔管肠腔内引流预防低位直肠癌吻合口瘘的效果研究[J].现代中西医结合杂志,2017,26(16):1770.
[3]杨程.骶前双管引流在治疗直肠癌术后吻合口瘘中应用[J].中国医学创新,2011,8(12):60-61.
[4]付晓云.自制冲洗引流器在直肠癌Miles术后的应用[J].中国临床研究,2012,25(6):583-584.
[5]佘加和,黄项武,董志勇.自制双套管持续冲洗治疗腹腔镜低位直肠癌根治术后吻合瘘[J].河北医科大学学报,2015,36(4);408-411.
[6]吴川清,刘炜圳,陶凯雄,等.骶前引流方式对直肠癌低位前切除术后吻合口瘘愈合的影响[J].腹部外科,2017,30(5):380.
[7]杨敏,杨智蓉.ELOCK引流管固定器在妇科恶性肿瘤患者腹腔镜术后的应用效果[J].当代护士(下旬刊),2017(11):58-61.
[8]洪澜,贺国丽,杨舒盈.腹壁切口缝合中皮下放置引流管在肥胖妇科肿瘤患者手术中的临床应用[J].实用妇产科杂志,2014,11(30):865-868.
[9]吕光东,杨高禄,郭振敏.中下段直肠癌术后双管联合肛管引流的应用[J].中国现在普通外科进展,2016,19(7):558.
[10]刘铁,孙军席,王海霞,等.持续负压引流配合间断冲洗对腹腔镜肛提肌外腹会阴联合切除术后手术部位感染的影响[J].中华胃肠外科杂志,2018,21(6):688-689.
[11]李世邦,刘牧林,孔令尚,等.我国直肠癌前切除术后发生吻合口瘘危险因素的Meta分析[J/OL].中华普外科学文献电子版,2013,7(3):52-56.
[12]田少林,高友兵.经肛门吻合口瘘引流治疗直肠癌保肛术后吻合口瘘临床疗效观察[J].中国实用外科杂志,2015.35(5):549-551,554.
[13]李卫冬,贾林.结直肠癌的社区筛查及早期诊治[J/OL].中华临床医师杂志(电子版),2015,9(5):13-15.
[14]羊涛,张嘉越,冷津立,等.肠腔内外双套管负压引流在左半结肠穿孔行一期修补术中的应用[J].中华普通外科杂志,2014,29(11):872-873.
[15]王维新,成德文,祁卫东.预置改良双套管治疗贲门癌、直肠癌术后吻合口瘘的临床研究[J].医学理论与实践,2013,26(24):3270-3271.
[16]张嘉越,黄永鸿,庞飞雄,等.肠腔内外双套管负压引流在左半结肠癌并急性梗阻一期切除吻合中的应用[J].中国普外基础与临床杂志,2015,22(3):307-311.
[17]欧明明,韩培彦,黄晓峰.一次性闭合高负压引流瓶在根治性颈淋巴结清扫术后应用的研究[J].临床和实验医学杂志,2017,16(12):1232-1234.
[18]李文霞,刘丹,黄淑俊.真空高负压引流与潘氏管双管引流在乳腺癌手术中的应用效果[J].中国医药导报,2015,12(35):99-102.
[19]刘江,李彦卿,郑海军,等.骶前双套管引流联合三腔管肠腔内引流预防低位直肠癌吻合口瘘的效果研究[J].现代中西医结合杂志,2017,26(16):1768-1770.