结直肠术后吻合口出血的预防与诊治探讨

Investigation of prevention and treatment of anastomotic bleeding after colorectal surgery

吻合口出血是结直肠术后比较常见的并发症,主要表现为术后患者持续或间断性血便。吻合口出血的危险因素主要包括手术操作不规范、手术方式(如腹腔镜下吻合)、肿瘤与肛缘的距离较近、结直肠良性疾病、结直肠术后吻合口漏或严重盆腹腔感染以及患者自身状况不佳等。规范化的手术操作和术中内镜检查等措施可以预防吻合口出血。吻合口出血大多为自限性疾病,通过补液、输血以及内镜治疗等保守治疗可以治愈,但对于严重的、危及到患者生命的吻合口出血,应果断采取手术治疗。

Anastomotic bleeding is a common complication after colorectal surgery,mainly manifesting as continuous or intermittent bloody stool.The risk factors for anastomotic bleeding mainly include suboptimal surgical skill,surgical methods(such as laparoscopic anastomosis),close distance between the tumor and the anal margin,benign colorectal diseases,anastomotic leakage after colorectal surgery,severe pelvic and abdominal infections,and the patient's own condition,etc.Anastomotic bleeding can be prevented by standardized operation and intraoperative endoscopic examination.Anastomotic bleeding is mostly a self⁃limited disease,which can be cured by conservative treatments such as fluid resuscitation,blood transfusion and endoscopic treatment.When serious anastomotic bleeding threatens the life of patients,surgical treatment should be taken into consideration decisively.