庆大霉素配合骶前引流管预防直肠癌术后吻合口瘘的应用研究

Application of gentamicin combined with presacral drainage tube in prevention of anastomotic leakage after rectal cancer operation

目的探讨庆大霉素配合骶前引流管在直肠癌术后预防吻合口瘘发生的临床应用效果。方法将郴州市第一人民医院普外科368例接受手术治疗的直肠癌患者按信封法分为观察组和对照组。其中对照组179例患者用骶前引流管进行术后吻合口瘘的预防;观察组189例患者在对照组基础上,术后第1天从骶前引流管注入庆大霉素注射液80 mg,随即夹闭引流管远端,50 min后放开。结果观察组189例中有1例发生吻合口瘘,发生率为0.52%;对照组179例中有6例发生吻合口瘘,发生率为3.35%。观察组吻合口瘘发生率低于对照组,两组比较差异有统计学意义(P<0.05)。结论庆大霉素注射液与骶前引流管配合冲洗引流可减少直肠癌术后发生吻合口瘘发生率,操作简便,效果显著。

Objective To investigate the clinical effect of gentamicin combined with presacral drainage tube in preventing anastomotic leakage after rectal cancer operation. Methods A total of 368 patients received surgical treatment of rectal cancer patients were randomly divided into the observation group and the control group. In the control group,179 patients were treated with presacral drainage tube to prevent anastomotic leakage. The observation group（189 cases） was treated with gentamicin（80 mg） injection on the basis of the control group at the first day after operation,and then the distal end of the drainage tube was clamped and released after 50 minutes. Results In 189 cases of the observation group,anastomotic fistula occurred in 1 patient. The incidence rate was 0. 52%. In 179 patients of the control group,there were 6 cases of anastomotic fistula. The incidence rate was 3. 35%. The observation group was significantly better than the control group,the difference was statistically significant（P〈0. 05）. Conclusions The combination of gentamicin injection and presacral drainage tube combined with irrigation and drainage has certain preventive effect on anastomotic leakage after rectal cancer operation.