不同手术方式一期治疗急诊左半结肠疾患的临床效果比较

目的：比较研究急诊左半结肠一期修补、切除吻合术的不同手术方式效果。方法：近4年我院收治的需手术治疗的左半结肠急诊患者60例，随机分为四组。对照组1行横结肠或乙状结肠预防性外置；对照组2采用损伤结肠或吻合口结肠外置；对照组3经肛门置入内引流管；治疗组经用长造瘘管经肛门置入预防性、可控性外置结肠近段。观察患者术后腹胀痛的临床症状、切口感染率、肠瘘发生率、住院时间。结果：各组切口感染率无统计学差异；治疗组腹部胀痛发生率低于对照1、2组；治疗组肠瘘发生率低于对照2、3组；治疗组住院时间低于对照各组。结论：治疗组可控性结肠外置在急诊左半结肠一期手术中具有优越性。

Compare the diffirent surgical methods of treatment on one - stage the emergency left colon

Object： To compare a repair of the emergency left colon, the effect of different surgical approach for resection and an- astomosis. Methods： Left colon in emergency patients required surgical treatment of the past four years our hospital, There are 60 ca- ses which are randomly divided into four groups. Control groupl, a line of the transverse colon or sigmoid preventive external; control group2, damage the colon or anastomotic colon external; control group 3 placed within the drainage tube through the anus; treatment group by using a long fistula placed in preventive through the anus, can be controllability of external colon proximal. Clinical symptoms observed in patients with postoperative abdominal pain and distension, wound infection, intestinal fistula incidence, duration of hospi- talization. Result： the wound infection rate was no significant difference, treatment group, abdominal pain incidence is lower than the control group 1 and 2, intestinal fistula incidence is lower than the control groups 2 and 3, length of stay lower than the control groups. Conclusion： controllability colon external is superior to the other surgical approachs in an emergency left colon surgery.