不同肠道准备法对结肠代食管术并发症的影响

Effects of different bowel preparation regimes on complications of esophageal replacement with colon

目的探讨降低结肠代食管术并发症的有效措施,筛选出最佳肠道准备法。方法对患食管中、上段癌拟行结肠代食管术的110例,随机分为2日准备法68例(A组);1日准备法36 例(B组)及术中准备法6例(C组),对比观察肠内容物排空状况、肠黏膜水肿程度、肠壁色泽、细菌数及与术后并发症率的相关性。结果 A组病例各项观察指标属优,术后并发症率低。C组术后并发症显著高于A、B组(P<0．01)。结论结肠代食管术前肠道准备以2 d准备法的肠腔内容物排空彻底,条件致病菌较少,术后并发症率低,所采取的措施易被患者接受,是理想的肠道准备法。

Objective To investigate the effective approaches to decrease the complications of esophageal replacement with colon （ERC） and to find the optimal preoperative bowel-cleansing. Methods One hundred and ten patients with esophageal carcinoma who underwent ERC were divided into 3 groups： cleaning bowels within 2 days （group A, n = 68 ）, cleaning bowels within 1 day （group B, n = 36）, cleaning bowels during operation （group C, n = 6 ）. The correlations were observed between the complications of ERC and the evacuation of intestinal contents, edema and color of intestinal mucosa, quantity of bacterium. Results The morbility of postoperative complication in group A was lower than other two groups. The morbility in group C was significantly higher than in groups A and B （P〈 0.01 ）. Conclusion Cleaning bowels in 2 days was an ideal preoperative bowel-cleansing for ERC. This regime can evacuate intestinal contents totally, reduce bacterium effectively, and decrease postoperative complications significantly.