无创固定自制冲洗引流管在Dixon术中的应用

Application of noninvasive fixation of self-designed tubes for lavage and drainage in Dixon surgery

目的探讨无创固定自制冲洗引流管在Dixon术应用中的可行性及优点。方法随访福州总医院2011年1月至2012年1月96例行Dixon手术患者,分为改良组(49例)及对照组(47例),改良组为造口袋无创固定组,对照组为丝线缝合固定组,观察Dixon术后两组冲洗引流管固定处感染情况、疼痛情况及其存在的优缺点。结果对照组有3例发生固定处感染,改良组无一例发生感染。对照组术后1 d固定处疼痛不明显,术后3、5、7 d固定处疼痛明显;而改良组术后7 d内固定处疼痛轻微。对照组中术后5 d有3例(6.38%)患者出现固定处丝线断裂,有2例(4.26%)缝合处出现切割伤;而改良组中术后6 d有2例(4.08%)出现造口袋圆形底盘脱落,1例(2.04%)过敏体质的患者粘贴处出现红疹及水泡等过敏表现。结论无创固定自制冲洗引流管在低位直肠癌手术中,可减少肛周固定处感染的风险,减轻术后固定处疼痛,具有一定的临床应用价值,但对于过敏体质患者应慎用。

Objective To assess the feasibility and advantage of noninvasive fixation of self-designed tubes for lavage and drainage in Dixon surgery. Methods Ninety-six consecutive patients who underwent Dixon surgery in the research institute of general surgery of Fuzhou General Hospital of Nanjing Military Command were randomly assigned into improvement group and control group, which the improvement group has 49 patients of improvement group received the self-designed tubes for lavage and drainage, while 47 patients of control group received the conventional fixation by silk. Local infection, pain conditions, advantages and disadvantages in two groups were observed. Results No local infection occurred in the improvement group, while 3 cases in the control group.The local pain condition in the control group is not obvious in one day after surgery, but it is obvious in three, five and seven day after surgery.The local pain condition in the improvement group is mild with seven days after surgery.In five day after surgery in the control group, silk breaks in three patients （6.38%） in a fixed place.While there are two cases （4.26%） occurring cutting in a fixed place. In six day after surgery in the improvement group, there are 2 cases （4.08%） appearing the chassis of ostomy round off fixed place in the fixed place. The allergic patient（2.04%） appears allergic rash, blisters and other allergic manifestations in the fixed place. Conclusion There has a certain the value in the clinical application in noninvasive fixation of self-designed tubes for lavage and drainage in Dixon surgery, which can decrease the risk of local infection and relieve local pain.But allergic patients should be cautious when they prepare to use it.