摘要
目的:探讨经盲肠末端回肠置管造瘘术(transcecum tube ileostomy,TTI)在保护结肠直肠高危吻合口的临床效果。方法:将我院63例有结肠直肠高危吻合口瘘因素的病人分为TTI组(32例)和造瘘组(31例),TTI组行结肠直肠原发病灶常规手术切除一期吻合后附加TTI,造瘘组行结肠直肠原发病灶常规手术切除附加预防性末端回肠造瘘,观察两组病人术后造瘘引流量、术后吻合口相关并发症发生率和造瘘相关并发症发生率、附加手术时间、再手术率、造瘘维持时间及治疗费用等,进行统计分析。结果:TTI组和造瘘组病人造瘘平均引流量分别为(520±60)mL/d和(630±80)mL/d;吻合口相关并发症发生率分别为15.6%(5/32)和45.2%(14/31);造瘘相关并发症发生率分别为12.5%(4/32)和38.7%(12/31);附加手术时间分别为(25±12)min和(40±24)min;再手术率分别为0和67.7%(21/31);造瘘维持时间分别为(17.6±3.4)d和(117.0±22.5)d;治疗费用分别为(31 500±3600)元和(40 300±3900)元,两组均具有统计学差异(P<0.05)。结论:附加TTI简单易行,转流肠内容物效果较好,对生活质量影响小,对结肠直肠高危吻合口有保护作用,且无需造瘘回纳,有一定的临床应用价值。
Objective To investigate the clinical effect of protecting colorectal anastomotic stoma with high risk by transcecum tube ileostomy （TTI）. Methods Sixty-three patients with high risk of colorectal anastomotic leakage in our hospital were divided into TrI group （32 patients）, who subjected additional TTI after colorectal lesion resection, and ileostomy group （31 patients）, who subjected additional terminal ileostomy after colorectal lesion resection and both with one-stage anastomosis. Clinical variables including the drainage from TTI or terminal ileostomy, the rate of complications related to anastomosis stoma and ostomy were compared between groups. Results The drainage from TTI and terminal ileostomy were （520±60） mL/d and （630±80） mL/d respectively. The rate of complications related to anastomotic stoma were 15.6% （5/32） and 45.2% （14/31）. The rate of complications related to ostomy were 12.5% （4/32） and 38.7% （12/31）. The operation time were （25±12） minutes and （40-±24） minutes. The reoperation rate were 0 and 67.7%（21/31）. The ileostomy was not closed until （17.6±3.4） days and （117.0±22.5） days later. The treatment fee was （31 500±3600） Yuan and （40 300 ±3900） Yuan. There were significant differences in all these variables between the two groups, P 〈0.05. Conclusions TTI is a simple, safe and effective method to drain the intestinal contents protecting the colorectal anastomotic stoma with high risk and least influence on the quality of life.
出处
《外科理论与实践》
2012年第5期472-476,共5页
Journal of Surgery Concepts & Practice
关键词
经盲肠末端回肠置管造瘘术
回肠造瘘
高危吻合口
Transcecum tube ileostomy
Terminal ileostomy
Anastomotic stoma with high risk
