镍钛记忆合金加压吻合器在胃肠吻合术中的应用

Gastroenteroanastomosis performed by the nickel-titanium memory-shaped device

目的探讨镍钛记忆合金加压吻合器在胃肠吻合中的应用及其意义。方法需行BilrothII式胃次全切除术患者分别施行镍钛记忆合金加压吻合器行胃肠吻合40例(A组)和手工缝合法行胃肠吻合40例(B组),比较两组患者术中胃肠吻合操作时间、出血量、术后排气时间、恢复进食时间、并发症,并观察吻合圈排出体外时间等指标。结果术中胃肠吻合操作时间,A组平均为(9.075±0.098)min,B组平均为(21.025±2.256)min;术中出血量A组平均为(559±74.756)mL,B组为(680±54.914)mL;术后排气时间A组平均为(80.400±8.714)h,B组平均为(96.050±11.005)h;以上3项两组比较,差异均有统计学意义(P<0.01)。术后进食时间,A组平均为(4.750±0.752)d,B组平均为(4.900±0.503)d,两组比较,差异无统计学意义(P>0.05)。两组术后均无胃肠吻合口瘘、狭窄、梗阻、出血等并发症发生。A组无吻合圈滞留体内情况出现,术后平均(10.900±1.832)d均排出体外。结论应用镍钛记忆合金加压吻合器行胃肠吻合能显著减少胃肠吻合操作时间及术中出血量,并能提前术后排气时间,且无并发症出现,术中植入的吻合圈均能安全排出体外,与常规手工行胃肠吻合比较优势明显,在胃肠吻合中具有广阔的前景,值得推广。

Objective To evaluate the application and significance of nickel-titanium memory-shaped device for gastroenteroanastomosis. Methods The patients for distant subtotal gastrectomy （BiUroth II） undergoing gastroenteroanastomosis were divided into two groups with either the nickel-titanium memoryshaped device （group A） for 40 cases or hand-made suture （group B） for 40 cases. The gastroenteroanastomosis time, the intraoperative bleeding quantity, the first flatus time, the first foodin- take time, and the complications were compared between the two groups. The extrusion time of anastomosis device were recor- ded. Results The gastroenteroanastomosis time in group A was （9.075±0. 098） rain, and that in group B was （21.025±2. 256） rain; The intraoperative bleeding quantity in group A was （559±74. 756） mL, and that in group was （680±54. 914） mL; The first flatus time in group A was （80. 400±8. 714） h, and that in group B was （96. 050±11. 005） h; the differences above all were statistically significant （P〈0. 0l）. The first foodintake time in group A was （4. 750±0. 752） d, and that in group B was （4. 900±0. 503） d, the difference was not statistically significant （P〈0.05）. There was no complication in each group, such as leakage, stenosis, obstruction or bleeding. The anastomosis device was expelled in （10. 900±1. 832） d after operation. Conclusion The gastroenteroanastomosis time, the intraoperative bleeding quantity, and the first flatus time under the gastroenteroanastomosis performed by the nickel-titanium memory-shaped device were less than that performed by hand-made suture. The complication was not found, and the anastomosis device was expelled safely. The nickel-titanium memory-shaped device is worth clinical application.