肠系膜下动脉高位与低位结扎对直肠癌根治术效果的分析

Analysis of the effect of high or low ligation of inferior mesenteric artery on radical resection of rectal cancer

目的探讨肠系膜下动脉高位与低位结扎在直肠癌根治术中的应用效果。方法选取2017年6月～2018年10月本院收治的60例直肠癌患者为研究对象,随机分为低位结扎组(A组)及高位结扎组(B组),每组各30例。A组行低位结扎肠系膜下动脉,B组行高位结扎肠系膜下动脉。比较两组术中肠系膜下动脉结扎后采用超声检测边缘动脉收缩期最大流速、舒张末期血流速度。统计两组术中情况及术后住院时间、肛门排气时间以及术后并发症发生率。结果 A组边缘动脉血流收缩期最大流速以及舒张末期血流速度均显著高于B组(P <0.05)。A组术后住院时间以及术后肛门排气时间均显著早于B组(P <0.05)。两组均无吻合口出血、肺栓塞、下肢静脉血栓形成的病例。A组在尿潴留与尿失禁发生率显著高于B组(P <0.05)。结论肠系膜下动脉高危结扎对边缘动脉血流影响相对较小,术后尿潴留、尿失禁的发生率相对较低。

Objective To discuss the effect of high or low ligation of inferior mesenteric artery on radical resection of rectal cancer. Methods Sixty patients with rectal cancer admitted to our hospital from June 2017 to October 2018 were randomly divided into low ligation group or high ligation group,30 cases in each group.Group A underwent low ligation of inferior mesenteric artery,and group B underwent high ligation of inferior mesenteric artery.The maximal systolic velocity and end-diastolic velocity of marginal artery were measured by ultrasound after ligation of inferior mesenteric artery in two groups.The intraoperative index,postoperative hospitalization time,anal exhaust time and the incidence of postoperative complications in the two groups were counted. Results The maximal systolic and enddiastolic flow velocities of marginal arteries in group A were significantly higher than those in group B(P < 0.05).The hospital stay and anal exhaust time in group A were significantly earlier than those in group B(P < 0.05).There were no cases of anastomotic bleeding,pulmonary embolism and lower extremity venous thrombosis in both groups.The incidence of urinary retention and incontinence in group A was significantly higher than that in group B(P < 0.05).Conclusion The high-risk ligation of inferior mesenteric artery has relatively little effect on the blood flow of marginal artery, and the incidence of urinary retention and incontinence is relatively low after operation.