低位直肠癌保肛术吻合口瘘原因分析及防治策略分析

Analysis of Causes of Anastomotic Leakage in Low Rectal Cancer and Its Prevention and Control Strategy

目的研究分析低位直肠癌保肛术吻合口瘘的原因以及对其预防的措施。方法选取2009年1月—2016年6月我院收取的153例接受低位直肠癌保肛术患者作为研究对象。按照术后吻合口瘘的情况,将其分为两组:发生组(16例)和未发生组(137例),对两组患者的临床资料等进行分析发生吻合口瘘的原因,并制定防治的措施。结果所有16例吻合口瘘患者,其中13例患者经过保守治疗均痊愈(81.25%),其余3例患者均实施横结肠造瘘术治疗,已经恢复健康,所有患者无死亡。结论低位直肠癌保肛术发生吻合口瘘的原因与吻合口血供、肥胖、肿瘤的分期和位置、患者疾病史等多种原因相关,预防吻合口瘘的发生需要术前充分的了解患者的病情、术中精准的操作、术后密切的观察患者的体征等,对增加手术治疗的疗效、降低术后吻合口瘘的发生率、改善和提高患者的生活质量水平的意义重大。

Objective To analyze the causes of rectal carcinoma operation anastomotic fistula research and the preventive measures. Methods From January 2009 to June 2016 in our hospital, 153 cases of patients received rectal cancer patients with anus operation were selected as the study object. According to postoperative anastomotic fistula, they were divided two groups： occurrence group （16 cases）and non-occurrence group （137 cases）, to analyze the causes of anastomotic fistula in two patients with clinical data, and prevention and control measures. Results All 16 patients with anastomotic leakage, 13 patients were cured after conservative treatment （81.25%）, with the remaining 3 cases implementation of the transverse colostomy surgery has recovered and all patient deaths. Conclusion Low rectal cancer insurance anus operation occurred anastomosis mouth fistula of reasons and anastomosis mouth blood for, and obesity, and tumor of staging and location, and patients disease history, variety reasons related, prevention anastomosis mouth fistula of occurred need operation of understand patients of illness, and operation in the precision of operation, and operation close of observation patients of signs, on increased surgery treatment of effect, and reduced operation Hou anastomosis mouth fistula of occurred rate, and improved and improve patients of life quality of level of meaning major.