摘要
目的探讨正中标本提取切口行预防性回肠造口对腹腔镜直肠癌根治术患者胃肠功能、炎症水平及吻合口瘘的影响。方法选取中国人民解放军联勤保障部队第904医院收治的腹腔镜直肠癌根治术患者160例,根据回肠造口方式分为研究组(正中标本提取切口行预防性回肠造口,n=88)和对照组(传统切口行预防性回肠造口,n=72),并比较2组胃肠功能、炎症水平、吻合口瘘愈合及发生情况和相关并发症发生情况。结果研究组术后首次排气时间、肠鸣音恢复时间和胃肠功能恢复时间均短于对照组(P<0.05)。治疗后3 d 2组血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平均有升高,但研究组低于对照组(P<0.05)。研究组治疗后吻合口瘘发生率低于对照组,吻合口瘘愈合时间短于对照组(P<0.05)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论正中标本提取切口行预防性回肠造口治疗腹腔镜直肠癌根治术患者胃肠功能恢复时间短、炎症水平较低、吻合口瘘愈合时间短,临床应用效果较好。
Objective To investigate the effect of preventive ileostomy with a median specimen extraction incision on gastrointestinal function,inflammation level,and anastomotic leakage in patients undergoing laparoscopic radical resection of rectal cancer.Methods A total of 160 patients who underwent laparoscopic radical resection of rectal cancer at the 904th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army were selected and divided into a research group(median specimen extraction for preventive ileostomy,n=88)and a control group(traditional incision for preventive ileostomy,n=72)based on the method of ileostomy.The gastrointestinal function and inflammation levels,the healing and occurrence of anastomotic fistula of the two groups,as well as the occurrence of related complications,were compared.Results The first postoperative exhaust time,bowel sound recovery time,and gastrointestinal function recovery time of the research group were shorter than those of the control group(P<0.05).At 3 d after treatment,serum hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)levels of the two groups all increased,which,however,were lower in the research group than in the control group(P<0.05).The incidence of anastomotic fistula in the experimental group was lower than that in the control group after treatment,and the healing time of anastomotic fistula was shorter than that in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Preventive ileostomy with a median specimen extraction incision in the treatment of patients undergoing laparoscopic radical resection of rectal cancer has shorter recovery time of gastrointestinal function,lower inflammation level,and shorter healing time of anastomotic fistula,suggesting good application effect in clinical practice.
作者
姚豪杰
王家淳
余锋
YAO Hao-jie;WANG Jia-chun;YU Feng(Department of General Surgery,the 904th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army,Jiangsu Province,Wuxi 214000,China)
出处
《河北医科大学学报》
CAS
2024年第9期1063-1067,共5页
Journal of Hebei Medical University
基金
江苏省自然科学基金面上项目(BK20191142)。
作者简介
姚豪杰(1984-),男,江苏江阴人,中国人民解放军联勤保障部队第904医院主治医师,医学学士,从事胃肠疾病诊治研究;通信作者:余锋,E-mail:22896201@qq.com。
