不同骶前沖洗引流裝置在直腸癌術(shù)患者并發(fā)癥中臨床應(yīng)用

亓德美　付霞　鄭珊紅　付曉云

【摘要】 目的：對(duì)比自制會(huì)陰骶前沖洗引流器與單腔引流器在低位直腸癌術(shù)后骶前腔引流過程中的臨床療效。方法：選取2012年7月-2017年7月在本院就診的82例直腸癌患者，遵循自愿的原則按入院時(shí)間隨機(jī)分為對(duì)照組（單腔引流器）和觀察組（自制會(huì)陰骶前沖洗引流器），每組各41例。對(duì)比兩組引流管拔管時(shí)間、住院時(shí)間等術(shù)后恢復(fù)情況指標(biāo)和術(shù)后吻合口瘺等并發(fā)癥發(fā)生情況。結(jié)果：觀察組引流管拔管時(shí)間和住院時(shí)間情況均明顯優(yōu)于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組術(shù)后并發(fā)癥發(fā)生率明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：低位直腸癌術(shù)后患者應(yīng)用自制會(huì)陰骶前沖洗引流器進(jìn)行骶前腔的間斷沖洗引流，能縮短引流管拔管時(shí)間和患者住院時(shí)間，更有利于減少術(shù)后吻合口瘺等并發(fā)癥的發(fā)生，有效提高患者術(shù)后生活質(zhì)量。

【關(guān)鍵詞】 低位直腸癌; 骶前腔沖洗引流; 自制會(huì)陰骶前沖洗引流器; 單腔引流器

【Abstract】 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.

【Key words】 Low rectal cancer; Presacral irrigation drainage; Self-made perineal presacral irrigation drainage device; Single lumen drainage device

First-authors address：Taian Cancer Prevention and Treatment Hospital，Taian 271000，China

doi：10.3969/j.issn.1674-4985.2019.13.013

直腸癌是消化道最常見的惡性腫瘤之一，其發(fā)病率和死亡率逐年上升，嚴(yán)重威脅著人們的生命、發(fā)病年齡以30～60歲居多[1]。由于直腸癌位于盆腔深處，解剖關(guān)系復(fù)雜，直腸癌手術(shù)對(duì)盆腔有很大的創(chuàng)傷，形成一個(gè)巨大的骶前空間，有出血和滲出液體[2]。骶前引流沖洗是否徹底、有效和充分將直接影響直腸癌患者術(shù)后并發(fā)癥的發(fā)生率。因此，選擇合適的引流裝置以達(dá)到最佳的引流效果和滿意的臨床效果非常重要。本研究使用一種自行設(shè)計(jì)的會(huì)陰骶前沖洗引流器（專利號(hào)：ZL200820023698.9）用于低位直腸癌患者術(shù)后沖洗引流，對(duì)本院近5年來行低位直腸癌Dixon或Miles術(shù)的82例患者進(jìn)行總結(jié)分析，以探討Dixon或Miles手術(shù)后自行設(shè)計(jì)的骶前沖洗引流器的沖洗引流效果?，F(xiàn)報(bào)道如下。

1 資料與方法