减张缝合+带蒂大网膜覆盖一期吻合治疗结肠梗阻的研究

Relaxation suture+pedicled omental covering a consistent progress in the treatment of bowel obstruction

目的:探讨减张缝合+带蒂大网膜覆盖一期吻合治疗结肠梗阻的临床疗效。方法:回顾性分析本院1982年4月～2002年5月收治入院的结肠梗阻患者283例,采取气管插管循环紧闭式复合静脉麻醉和连续硬膜外腔麻醉,从阑尾插管顺行灌洗肠道,均行减张缝合+带蒂大网膜覆盖一期吻合术。结果:观察组86例患者的总有效率为69.77%,对照组总有效率为55.81%,两组比较差异有统计学意义,P<0.05;两组患者手术前后临床分期无明显差异,P>0.05,两组并发症比较,P<0.05。结论:肠道减压排空处理减张缝合+带蒂大网膜覆盖一期吻合治疗结肠梗阻,具有预防吻合口狭窄、改善吻合口血供、促进吻合口愈合及增加一层保护措施的作用,能有效预防及减少梗阻性左半结肠癌一期切除吻合术后吻合口漏的发生。该方法治疗左半结肠癌并急性肠梗阻是可行而安全的。

Objective：To explore the relaxation suture ＋ pedicled omental covering a consistent treatment of the clinical efficacy of bowel obstruction.Methods：A retrospective analysis of our hospital in April 1982-2002 years in May of patients admitted to hospital in 283 cases of bowel obstruction,tracheal intubation to shut compound intravenous anesthesia and continuous epidural anesthesia,antegrade intubation from appendectomy intestinal lavage were relaxation suture line ＋ pedicled omental covering an anastomosis.Results：The group of 86 patients with total effective rate was 69.77%,control group was 55.81 percent effective,the difference significant,P〈0.05;two groups before and after surgery in patients with clinical stage,no significant difference,P〉0.05.Complication compared with the control group,P〈0.05.Conclusion：Intestinal decompression venting suture ＋ pedicled omental covering a consistent treatment of colonic obstruction,with pre vention of anastomotic stenosis,improved anastomotic blood supply,promote healing and increase a layer protection mea sures,it can effectively prevent and reduce obstructive left colon resection and anastomosis of an occurrence of anastomotic leakage.This method is feasible and safe of the treatment of acute intestinal obstruction of left colon cancer.