磷酸钠盐口服溶液在低位直肠癌保肛术肠道准备中的应用

Application of sodium phosphate oral solution in anus-preserving operation for low rectal cancer in the bowel preparation

目的总结应用一次性肛肠吻合器(PPH)完成超低位直肠癌结肠肛管吻合术要点,分析磷酸钠盐口服溶液在低位直肠癌保肛术肠道准备中应用的临床效果。方法选择涿州市医院2011年5月至2012年6月收治的69例超低位直肠癌患者,按照数字表随机分为试验组(35例)和对照组(34例),分别采用口服磷酸钠盐口服溶液与口服蓖麻油方法行术前肠道准备,应用PPH器械完成超低位直肠癌结肠肛管吻合术。比较两组患者的一般临床资料,术前准备时间和不适症状,术中肠壁水肿、出血量、肠腔清洁情况,以及术后肠道恢复时间、腹泻等指标。结果 69例患者手术顺利。在术前准备时间、其间不适症状、术中肠壁水肿、术后肠道恢复时间方面,试验组优于对照组(P<0.05);但在术中出血量、术中肠腔清洁、术后腹泻方面,两组差异无统计学意义。结论磷酸钠盐口服溶液进行肠道准备耗时短,术中肠壁水肿轻,清洁效果显著,术后肠道恢复时间短,不良反应较少,安全、有效、实用,值得临床推广。

Objective To sum up the key points of disposable anorectal stapling technique PPH to complete the super low rectal cancer coloanal anastomosis, and to analyze the clinical effect of sodium phosphate oral solution in anus preserving operation for low rectal cancer in the bowel preparation. Methods Sixty-nine cases of low rectal cancer in Zhuozhou City＇s Hospital from May 2011 to June 2012 were, in accordance with the digital meter, randomly divided into experimental group （35 cases） and control group （34 cases）, respectively. The experimental group was given oral sodium phosphate solution, and the other group oral castor oil. PPH devices were used to complete the ultra-low ：rectal cancer colon anal anastomosis. Comparison of the two groups was carried out on such clinical data as preoperative preparation time, postoperative symptoms, midgut wall edema, bleeding, intestinal cavity cleanliness, and postoperative intestinal recovery time, diarrhea index. Results The 69 operations were smooth. As for preparation time, intraoperative symptoms, wall edema, and postoperative recovery, the experimental group was better than control group 00〈0.05）; but in the intraoperative blood loss, postoperative intestinal cavity clean, and diarrhea, there was no statistically significant difference between the two groups. Conclusions The time of sodium phosphate oral solution for bowel preparation is short; there is less intraoperative wall edema, better cleaning effect, and the time for postoperative intestinal recovery is short. The less adverse reaction, safety and effect are worth the clinical promotion.