自制低负压吸引器治疗B级胃肠术后吻合口漏的临床疗效

目的 分析自制低负压吸引器治疗B级胃肠术后吻合口漏的临床应用价值.方法 回顾性分析了安徽医科大学附属合肥医院2012年1月-2016年3月的21例胃肠术后发生B级吻合口漏患者的治疗方式.其中再次手术9例(手术组),放置自制低负压吸引器通过引流12例(引流组),通过t检验和Fisher确切概率法对漏后住院天数、漏后住院费用、术后反复腹疼腹胀、术后肠外瘘、病死率进行统计学对比来了解不同治疗方式的的临床效果.结果 手术组死亡2例,治愈7例,术后出现并发症4例(肠漏1例、切口感染3例);引流组均治愈出院.电话随访2个月～4年,手术组和引流组漏后住院天数分别为(56.71±16.41)d、(35.92±14.65)d,漏后住院费用(8.46±1.32)万元、(4.40±0.93)万元,差异均有统计学意义(P＜0.05);手术组反复腹痛、腹胀3例,肠外瘘0例;引流组反复腹痛、腹胀5例,肠外瘘1例.结论 自制低负压吸引器引流可作为胃肠手术后吻合口漏的重要治疗措施,具有操作简单、安全、住院时间短、费用低等优点.

Application of homemade low negative pressure aspirator in anastomotic leakage of B after gastrointestinal surgery

Objective To analyze clinical effect of gastrointestinal anastomotic leakage of B by homemade low negative pressure aspirator.Methods The 21 cases of gastrointestinal anastomotic leakage of B were performed to analyze the therapeutic effect for 21 cases of gastrointestinal anastomotic leakage of B treatment from Jan.2012 to Mar.2016 in Gastrointestinal Surgery,Anhui Medical University of Hefei Affiliated Hospital,through the leakage after hospitalization days,leakage after hospitalization expenses,postoperative recurrent abdominal pain or distension,postoperative enterocutaneous fistula,mortality by t test and Fisher exact probability method.Among them 9 cases of reoperation (surgery group) and the other 12 cases placed homemade low negative pressure aspirator to drainage (drainage group).Results Surgery group of 2 cases died,7 cases were cured,postoperative complications occurred in 4 cases (1 cases of intestinal leakage,3 cases of incision infection);drainage group were all cured and discharged.Followed up for 2 months to 4 years by telephone,surgery and drainage group of hospitalization days respectively after leakage (56.71 ± 16.41) days,(35.92 ± 14.65) days,leakage after hospitalization expense (RMB ten thousand) (8.46 ± 1.32),(4.40 ± 0.93) which had statistical significance (P ＜ 0.05).Three cases of recurrent abdominal pain or distension and 0 cases of intestinal fistula in surgery group,which were 5 and 1 in drainage.Conclusions The homemade low negative pressure aspirator drainage can be used as important treatment of anastomotic leakage after gastrointestinal surgery,which has some advantages of the simple technique,safety,and shorter hospitalization time and lower cost and so on.