美兰在术中检测直肠癌吻合口漏的应用

Methylene Blue in the Intraoperative Detection of Rectal Anastomotic Leakage

目的观察美兰在术中检测预防直肠癌术后吻合口漏的应用。方法入组病例共151例，剔除无法切除肿瘤或不适宜结直肠吻合的病例19例，进入临床研究病例共132例，研究组65例，对照组67例。年龄37—85岁，平均58．7岁；男性75例，女性57例，男女比例1．32；肿瘤下极距肛缘5．0-11．0cm（术中测量），平均6．4cm；肿瘤大小3．5—9．5cm，平均5．2cm；择期手术121例，急诊手术11例。研究组在完成肠吻合后从肛门注入美兰1支＋生理盐水50mL，观察吻合口有无关兰渗漏。术后6个月随访率100％。两组患者对比术后吻合口漏发生率。结果术中使用关兰溶液检测吻合口，术后吻合口漏发生率明显低于对照组，两组比较差异有统计学意义（P〈0．05）。结论术中使用美兰溶液检测直肠癌切除后吻合口，定位准确，直视下修补，明显降低或避免了直肠癌术后吻合口漏的发生，该法简单实用，值得推广。

Objective To observed value of methylene blue solution in the prevention of rectal cancer surgery anasto- motic leakage. Methods Into the group of cases of 151 cases, excluding 19 cases of unresectable tumors or unfit rectal anastomosis cases, into a total of 132 cases of clinical research,Study group of 65 patients in the control group （67 ca- ses）. Age 37 years to 71 years, with an average of 59.7 years of age; 53 cases of 79 cases of male, female, male to fe- male ratio of 1.49 ; Tumor under the pole away from the anal verge 5.0 cm ~ 11.0 cm （ intraoperative measurement）, an average of 6. 4 cm; tumor size 3. 5 cm ~9. 5 cm, an average of 5. 2 cm. On the one hand; Elective surgery 121 cases, 11 cases of emergency surgery, enteric anastomosis is completed, the study group injected 50 ~ 100 ml Methylene blue solution from the anus to observe any leaks anastomotic. After 6 months of follow - up rate of 100%. The two groups of pa- tients comparing the incidence of anastomotic leakage. Results Intraoperative use of the Meilan research group anasto- motic leakage was significantly lower than the control group, the difference was statistically significant （P 〈 0. 05）. Con- clusions The intraoperative use of Methylene blue solution after the detection of rectal cancer resection anastomosis is intact and thus accurate repair, reduce the incidence of anastomotic leakage,worthy of promotion.