[1]吴 明,侯 斌,陈 朝,等.预防性末端回肠造瘘与结肠造瘘在低位直肠癌保肛术中的效果比较[J].医学信息,2021,34(06):129-131,135.[doi:10.3969/j.issn.1006-1959.2021.06.033]
　WU Ming,HOU Bin,CHEN Chao,et al.Comparative Study of Preventive Terminal Ileostomy and Colostomy for Anus Preservation in Low Rectal Cancer[J].Medical Information,2021,34(06):129-131,135.[doi:10.3969/j.issn.1006-1959.2021.06.033]
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预防性末端回肠造瘘与结肠造瘘在低位直肠癌保肛术中的效果比较()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年06期
页码:
129-131,135
栏目:
临床研究
出版日期:
2021-03-15

文章信息/Info

Title:
Comparative Study of Preventive Terminal Ileostomy and Colostomy for Anus Preservation in Low Rectal Cancer
文章编号:
1006-1959（2021）06-0129-04
作者:
吴 明; 侯 斌; 陈 朝; 等
（重庆医科大学附属第一医院胃肠外科，重庆 400000）
Author(s):
WU Ming; HOU Bin; CHEN Chao; et al.
(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)
关键词:
低位直肠癌; 末端回肠造瘘; 结肠造瘘; 吻合口瘘; 电解质紊乱
Keywords:
Low rectal cancer; Terminal ileostomy; Colostomy; Anastomotic fistula; Electrolyte disturbance
分类号:
R735.3
DOI:
10.3969/j.issn.1006-1959.2021.06.033
文献标志码:
A
摘要:
目的 比较低位直肠癌手术后行临时预防性末端回肠造瘘术或结肠造口术临床效果，观察其对患者的影响。方法 回顾性分析我院2015年4月~2019年12月收治的低直肠癌手术患者99例，根据造瘘情况分为末端回肠造瘘组49例和结肠造瘘组50例，比较两组造瘘及还纳术后相关并发症发生情况（吻合口瘘、吻合口狭窄、造瘘口脱垂/回缩、梗阻、感染）、相关实验室指标水平（白蛋白、白细胞、中性粒细胞、Na、K紊乱）及还纳手术情况（手术时间、排气排便时间、住院时间）。结果 两组吻合口瘘、吻合口狭窄、造瘘口脱垂/回缩、造瘘口梗阻及造瘘口周围感染发生率比较，差异无统计学意义（P＞0.05）；结肠造瘘组还纳后切口感染发生率高于末端回肠造痿组，差异有统计学意义（P＜0.05）；结肠造瘘组在还纳后白细胞水平、中性粒细胞水平及还纳后电解质紊乱（Na、K）发生率高于末端回肠造瘘组，差异有统计学意义（P＜0.05）；结肠造瘘组还纳术后住院时间、排气排便时间及住院时间高于末端回肠造瘘组，差异有统计学意义（P＜0.05）。结论 结肠与末端回肠造瘘在低位直肠癌保肛预防吻合口瘘方面效果基本一致，但末端回肠造瘘术在减少电解质紊乱和并发症，缩短住院时间，加快术后康复方面优于结肠造瘘术。
Abstract:
Objective To compare the clinical effects of temporary preventive terminal ileostomy or colostomy after surgery for low rectal cancer, and to observe its impact on patients.Methods A retrospective analysis of 99 cases of low rectal cancer surgery patients admitted to our hospital from April 2015 to December 2019.According to the fistula situation, they were divided into 49 cases in the terminal ileostomy group and 50 cases in the colostomy group. The two groups were compared with the fistula and postoperative complications (anastomotic fistula, anastomotic stenosis, prolapse/retraction of the stoma, obstruction, infection), the level of related laboratory indicators (albumin, white blood cells, neutrophils, Na, K disorders) and the status of the surgery (operating time, exhaust and defecation time, hospital stay).Results There was no significant difference in the incidence of anastomotic leakage, anastomotic stenosis, prolapse/retraction of the stoma, obstruction of the stoma, and infection around the stoma between the two groups (P>0.05);The incidence of incision infection in the colostomy group was higher than that in the terminal ileal fistula group after reconciliation,the difference was statistically significant (P<0.05);In the colostomy group, the incidence of white blood cell level, neutrophil level and electrolyte disturbance (Na, K) after the reduction was higher than that of the terminal ileostomy group,the difference was statistically significant (P<0.05);The colostomy group also included higher postoperative hospital stay, exhaust and defecation time and hospital stay than the terminal ileostomy group,the difference was statistically significant (P<0.05).Conclusion Colon and terminal ileostomy have basically the same effect in preventing anastomotic leakage in low rectal cancer, but terminal ileostomy can reduce electrolyte disturbance and complications.It is better than colostomy in shortening the length of hospitalization and speeding up postoperative recovery.

参考文献/References:

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更新日期/Last Update: 1900-01-01