直肠癌Miles术后会阴部切口感染的原因分析

目的：研究直肠癌术后会阴部切口感染的原因.方法：120例直肠癌患者均采用标准的Miles手术方式.A组：关闭盆底,经右下腹骶前间隙双套管负压吸引,间断夹闭尿管（5 d）的患者30例;B组：关闭盆底,经右下腹骶前间隙单管引流,间断夹闭尿管（5 d）的患者30例;C组：关闭盆底,经右下腹骶前间隙双套管负压吸引,持续开放尿管（5d）的患者30例;D组：不关闭盆底,经右下腹骶前间隙双套管负压吸引和间断夹闭尿管（5 d）的患者30例.结果：A、B、C、D组会阴部切口感染率分别为13.3％,23.3％,19.7％和20.0％.A组与B组、A组与C组、A组与D组比较,差异均有统计学意义（x2=1.105,P＜0.05）.结论：会阴部切口感染与术后骶尾前间隙积液引流是否通畅、骶尾前间隙残腔是否能及时闭合、盆底腹膜是否关闭均有关.

Clincil analysis on the causes of perineal wound infection in rectal cancer after Miles operation

Objective：To study the causes of perineal wound infection in rectal cancer after Miles operation. Methods： One hundred and twenty patients with rectal cancer adopt standard means of Miles operation. Group A ： closed the pelvic floor, the fight lower abdomen presacral space double pipe pressure suction, discontinuous closed urine tube （5 days） to 30 cases of patients. Group B：Closed the pelvic floor, the right lower abdomen presacral space single tube drainage, discontinuous close urine tube （5 days） to 30 cases of patients. Group C：Closed the pelvic floor, the Right lower abdomen presacral space double pipe pressure suction, continue to open the urine tube （5 days） to 30 cases of patients. Group D ： Disclose the pelvic floor, the right lower abdomen presacral space double pipe pressure suction, discontinuous closed urine tube （5 days） to 30 cases of patients. Results：The perineal wound infection rate of group A, B, C and D was 13.3% ,23.3% , 19.7% and 20.0%. There was significient difference between group A and group B , between group A and group C , between group A and group D （ P 〈 0.05 ）. Conclusion ： Perineal wound infection presacral space is unobstructed fluid drainage, presaeral space residual cavity before is closed in time. Pelvic peritoneum is closed relation.