术中结肠灌洗在左半大肠癌并急性肠梗阻Ⅰ期切除吻合中的研究

目的探讨术中结肠灌洗在左半大肠癌并急性肠梗阻Ⅰ期切除吻合中的应用价值。方法对我科2006年收治86例左半结肠癌并急性肠梗阻Ⅰ期切除吻合进行回顾性分析。根据术中采用不同的肠道准备方法,86例患者被随机分为全结肠灌洗组(39组)及单纯肠道减压组(47例)。结果全结肠灌洗组并发症发生6例,发生率15.4%,死亡1例,死亡率2.6%。单纯肠道减压组发症发生8例,发生率17.0%,死亡2例,死亡率4.3%。非灌洗组和灌洗组并发症发生率两者间差异无统计学意义(P=0.838)。结论左半大肠癌并急性肠梗阻Ⅰ期切除吻合是安全可靠的,疗效满意。不同术中肠道准备不是影响治疗效果的关键,不灌洗肠腔是可行的。

Study on intraoperative colonic lavage in the use of one stage resection and anatomosis for left semi-large intestinal cancer associated with obstruction

Objective To investigate the applied value of intra-operative colonic lavage in one stage resection and anastomosis for left semi-large intestinal cancer associated with obstruction.Methods From May 2005 to October 2006,86 cases with left semi-large intestinal cancer received one stage resection and anastomosis were analyzed retrospectively.According to use of the different method of intraoperative intestinal preparation,86 cases were randomly divided into whole colonic lavage group(39 cases)and simple intestinal decompression group.Results The postoperative complications of whole colonic lavage group was 6 cases(6/39,15.4%)and 1 case died,the mortality rate was 2.6%.The postoperative complications of simple intestinal decompression group was 8 cases(8/47,17%)and 2 cases died,the mortality rate was 4.3%.There was no significant dierence between 2 groups(P=0.838).Conclusion One stage resection and anastomosis has a safe,reliable and satisfactory therapeutic efficacy for treatment of left semi-large intestinal cancer associated wtith obstruction.Differnet intraoperative intestinal preparation is not the key points to influence curative effect and without large intestinal lavage is practicable.