直肠癌术中骶前静脉丛破裂大出血的防治探讨

目的:探讨直肠癌根治术中骶前静脉丛破裂大出血的常见原因和防治方法。方法:对我科进行的直肠癌根治术患者进行系统性分析，术中发生骶前静脉丛破裂大出血7例，术中按出血部位和手术进展情况分别采取止血钉钉压、碘仿纱条填塞法止血。结果:6例止血成功并痊愈出院，1例因止血失败出血死亡。结论:手术操作不当是导致术中骶前静脉丛破裂大出血的主要原因，实行全直肠系膜切除(TME)是预防骶前静脉丛破裂大出血的关键。止血钉钉压和碘仿纱条填塞是治疗术中骶前静脉丛破裂大出血的有效方法。

Study on the methods of prevention and treatment of presacral venous plexus massive hemorrhage during operation of rectal cancer

Objective To study the common cause of the presacral venous massive hemorrhage and the methods of prevention and treatment during the operation of rectal cancer.Methods From January 1999 to June 2003,7 cases with presacral venous massive hemorrhage during the operation of rectal cancer were analyzed retrospectively.According to the site and status of bleeding,the drowing pin and iodoform guaze were used to control the bleeding.Results Hemotasis was obtained successfully in 6 cases and they were cured to discharge from hospital. One case died from hemostatic failure. Conclusion Main cause of presacral venous massive hemorrhage is due to unsuitable surgical manipulation.TME is the key point to prevent presacral venous massive bleeding.Dressing grawing pin and lodoform gauze tamponade are effective method for treating the presacral venous massive bleeding.