结肠内置管引流治疗结直肠创伤术后吻合口漏

Effects of Drainage by Double Perianastomotic Proximal and Distal Tubes Upon Postoperative Leaking in Left Colonic and Rectal Trauma

目的 了解吻合口上下双管引流法对左半结肠、直肠创伤一期手术后吻合口漏的治疗作用。方法 对 2 8例左半结肠、直肠创伤一期手术后出现吻合口漏的病人 ,采用肠腔内吻合口上下双管引流 ,以临床症状、体征、X线检查和骶前引流物为指标 ,对吻合口漏愈合时间进行了观察 ,同时与 2 5例吻合口漏患者采用单纯扩肛的方法进行比较。结果 使用双管引流病人吻合口漏的愈合时间为 10 .4± 2 .3d ,比单纯扩肛病人的 14.7± 5 .1d明显缩短 (P <0 .0 5 )。结论 吻合口上下双管引流法可明显缩短左半结肠、直肠创伤一期手术后吻合口漏愈合时间 ,对吻合口漏有明显的治疗作用。

Objective To evaluate the effects of drainage by double perianastomotic proximal and distal tubes upon postoperative leaking after one-stage resection in left colonic and rectal trauma. Methods In 28 patients suffering from anastomotic leaking after one-stage resection in left colonic and rectal trauma, double perianastomotic proximal and distal tubes were placed for the purpose of decompressing and draining. Clinical symptoms and signs, abdominal X-ray examinations and presacral drains were used as indices of clinical healing. The healing time of anastomotic leaking was observed, and was compared with that in a group of 25 patients to whom anal dilation was used as the method of drainage. Results The healing time in the group of drainage by double perianastomotic proximal and distal tubes was 10.4±2.3 d. Compared with that in the group of anal dilation(14.7±5.1 d), the healing time was significantly shortened( P <0.05). Conclusion Drainage by double perianastomotic proximal and distal tubes can decrease the healing time of postoperative anastomotic leaking after one-stage resection in left colonic and rectal trauma, and has good therapeutic effects upon anastomotic leaking.