回肠双造口在结肠扭转手术中的应用

The application of double ileostomy in operations of colonic volvulus

目的介绍回肠双造口在结肠扭转手术中的应用,并比较此法与其他方法的不同。方法将我院胃肠外科2005年-2012年收治的结肠扭转患者39例分为2组,其中一组行一期吻合手术,另一组行一期吻合后加做回肠保护性双造口手术,比较两组在手术时间、切口感染,术后腹腔出血、术后吻合口漏、总住院时间发生率和死亡率之间的不同。结果两组在术后腹腔出血、死亡率和术后切口感染方面比较差异无统计学意义(P>0.05),而加做回肠造口后吻合口漏明显下降,但手术时间(127.76±11.86)min和总住院时间(20.00±1.97)d明显延长。结论在结肠扭转时切除扩张扭转的部分结肠并一期吻合后加做回肠造口虽然耗费时间,但手术更安全。

Objective To introduce the clinical application of double ileostomy in operations of colonic volvulus.Methods 39 colonic volvulus patients were divided into 2 groups from 2005 to 2009 in our hospital, primary colocolic anastomosis was performed in group A; primary eolocolie anastomosis with double ileostomy was performed in group B. Operation time, wounds infection, postoperative abdominal haemorrhage, postoperative stomal leak, total hospitalization time and mortality were compared. Results there are not different in wounds infection and postoperative abdominal haemorrhage, but the rate of stomal leak and mortality was sigmificant higher in group A, but it took more time in group B. Conclusion The primary colocolic anastomosis with double ileostomy in operations of colonic volvulus is more safer though it took more time.