圆形吻合器在肠造口术中的应用研究

Comparative study of circular stapler and conventional colostomy in enterostomy

目的探讨圆形吻合器在肠造口术的应用价值。方法回顾分析2010年3月至2012年3月在解放军福州总医院接受同一外科治疗小组手术的70例圆形吻合器肠造口术患者(吻合器组)的造口手术时间,术后造口并发症、感染发生率及随访情况。并与同期行传统手工肠造口术的51例患者(手工组)进行比较。结果两组均无手术死亡病例。吻合器组造口时间(12.66±2.28)min;术后发生造口狭窄、造口渗血各1例(2.86%),切口感染1例(1.43%)。手工组造口时间(24.74±2.83)min;术后发生造口并发症7例(13.73%),分别是造口缺血1例、造口狭窄2例、造口回缩2例、造口旁疝2例,另切口感染2例(3.92%)。两组造口时间、造口并发症发生率比较差异有统计学意义(P<0.05),术后感染发生率比较差异无统计学意义(P>0.05);术后随访6~24个月,吻合器组患者1年内造口吻合钉逐渐脱落。结论圆形吻合器行肠造口术具有操作简便,并发症少,外形美观,护理方便等优点。

Objective To evaluate the application value of circular stapler in intestine stomy. Meth- ods A total of 70 cases of intestine storey underwent circular stapler by the same surgical treatment group and 51 case of traditional stomy from Fuzhou General Hospital of PLA were selected during Mar 2010 to Mar 2011. The operation time, complications, infection and follow-up were compared between the two groups. Results During the follow-up of 6 - 24 months, the follow-up rate of staplers group was 97% and the stoma time was （ 12. 66 ± 2. 28） minutes without any postoperative deaths. There were 2 cases of stoma complications including 1 case of stoma stenosis and 1 case of stoma bleeding with the rate of 2. 86%. There was 1 case of wound infec- tion with the rate of 1.43% and the staples would be off after 1 year. The follow-up rate of traditional manual group was 98 % and the stoma time was （24. 74 ± 2. 83） minutes without any postoperative deaths. There were 7 cases of stoma complications including 2 cases of stoma stenosis, 1 case of stoma ischemia, 2 cases of stoma retraction, 2 cases of parastomal hernia with the rate of 13.73%. There was 2 cases of wound infection with the rate of 3.92%. There were no significant differences between the two groups in complication and infection rate （P 〉 0.05）, and the difference in operation time was statistically significant （P 〈 0. 05 ）. Conclusions Cir- cular stapler is a new safety efficacious method for treating intestine storey. It is popularized in the treatment of patients for significant clinical effect, few complications, convenient in nursing and lower recurrence rate.