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Miles术后会阴缝合切口感染的防治
引用本文:黄平,王锋,杨小冬,肇毅,高一飞,沈杰,陈贤贵,李德川,楼荣灿. Miles术后会阴缝合切口感染的防治[J]. 中国现代手术学杂志, 2009, 13(1)
作者姓名:黄平  王锋  杨小冬  肇毅  高一飞  沈杰  陈贤贵  李德川  楼荣灿
作者单位:1. 南京医科大学第一附属医院普外科肛肠组,南京,210029
2. 浙江省肿瘤医院大肠癌外科,杭州,310022
摘    要:
目的研究M iles术后骶前引流和会阴缝合切口的处理方法。探索M iles术后会阴切口感染的防治方法。方法109例直肠癌M iles手术患者,随机分为A组57例,行经会阴切口旁骶前引流;B组52例,联合行经右髂部合并经会阴切口旁骶前引流。如术后发生会阴切口感染,A组拔除经会阴切口旁引流管行开放换药;B组除拔除经会阴切口旁引流管行开放换药外,同时保留经右髂部引流管进行主动引流。结果A组会阴切口感染率为19.3%(11/57),与B组的17.3%(9/52)比较,无统计学差异(P>0.05)。会阴切口感染后,A组换药时间为35~50 d,平均(42.8±5.4)d;B组换药时间为21~35 d,平均为(27.8±4.9)d,A组明显长于B组,P<0.05。结论M iles术后联合经右髂部合并经会阴切口旁骶前引流有利于盆腔创面的愈合;一旦会阴切口发生感染,拔除经会阴切口旁引流管,保持经右髂部引流管进行主动引流,会阴切口经换药可较快愈合。

关 键 词:直肠肿瘤  Miles术  引流术

Prevention and Treatment of Sutared Perineal Wound Infection after Mile's Operation
HUANG Ping,WANG Feng,YANG Xiao-dong,ZHAO Yi,GAO Yi-fei,SHEN Jie,CHEN Xian-gui,LI De-chuan,LOU Rong-can. Prevention and Treatment of Sutared Perineal Wound Infection after Mile's Operation[J]. Chinese Journal of Modern Operative Surgery, 2009, 13(1)
Authors:HUANG Ping  WANG Feng  YANG Xiao-dong  ZHAO Yi  GAO Yi-fei  SHEN Jie  CHEN Xian-gui  LI De-chuan  LOU Rong-can
Affiliation:HUANG Ping; WANG Feng; YANG Xiao-dong; ZHAO Yi; GAO Yi-fei; SHEN Jie; CHEN Xian-gui; LI De-chuan; LOU Rong-can(Department of Colorectal Surgery; First Affiliated Hospital of Nanjing Medical University; Nanjing 210029; Jiangsu; China);
Abstract:
Objective To explore the methods and efficacies of presacral drainage in patients with rectal cancer after Miles operation.Methods 109 patients with rectal cancer underwent Miles operations were divided randomly into two groups.In Group A,there were 57 patients placed a presacral drainage tube beside the transperineal incision.In Group B,there were 52 patients placed two combined presacral drainage tubes,of which one beside the transperineal incision,and the other was placed through the right iliac region.I...
Keywords:rectal neoplasms  Miles procedure  drainage
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