术中灌洗对左半结肠破裂一期修复疗效的影响

Effect of intraoperative irrigation for a repair therapy in left colon rupture

目的研究术中结肠灌洗对左半结肠破裂一期修复(一期缝合修补或肠切除吻合)疗效的影响。方法将15例行术中结肠灌洗后一期修复的左半结肠破裂患者作为处理组;15例未行术中结肠灌洗仅行肠腔减压的左半结肠破裂一期修复患者作为对照组。就两组患者术后结肠漏发生率、切口感染率、肛门排气时间、住院时间进行对比分析。结果处理组无结肠漏发生(0.00%),发生切口感染1例(占6.67%),肛门排气时间2～4d,平均(3.25±0.85)d,住院时间7～14d,平均(8.43±1.76)d;对照组发生结肠漏4例(占26.67%),切口感染6例(占40.00%),肛门排气时间3～6d,平均(5.13±1.02)d,住院时间10～18d,平均(12.85±2.32)d。处理组与对照组比较,术后结肠漏发生几率、切口感染率均低,差异有统计学意义(χ2分别=4.62、4.67,P均<0.05);术后肠功能恢复快(术后肛门排气时间短)及住院时间短,差异有统计学意义(t分别=5.48、5.88,P均<0.05)。结论左半结肠破裂一期修复患者术中行结肠灌洗有利于减少结肠漏、切口感染等并发症,并有利于术后肠功能恢复及减少住院时间。

Objective To explore therapeutic effect of intraoperative colonic irrigation for a repair in left colon rupture.Methods Fifteen patients with a repair of left colon rupture received intraoperative colonic irrigation were regarded as a treatment group;15 cases with no intraoperative colonic irrigation but the line-line decompression before a repair of the left colon rupture were regarded as the control group patients.The occurrence of postoperative risk of colon leakage,wound infection,anal exhaust time and hospital stay in two groups were analyzed.Results No colon leakage occurred in the treatment group（0.00%）,the occurrence of wound infection in 1 cases（6.67%）,anal exhaust time 2 to 4 days [average（3.25 ± 0.85）d],length of hospital stay 7 to 14 days[average（8.43 ± 1.76）d].In the control group,colon leakage occurred in 4 cases（26.67%）,wound infection in 6 cases（40.00%）,anal exhaust time 3 to 6 days[average（5.13 ± 1.02）d],length of hospital stay 10 to 18 days [average（12.85 ± 2.32）d].There were significant differences between the two groups（χ2=4.62,4.67;t=5.48,5.88,P0.05）.Conclusions A repair of the left colon rupture after intraoperative colonic irrigation can help to reduce colon leakage,wound infection and other complications,and help restore bowel function and reduce hospital stay.