回肠末端悬吊术在腹腔镜下低位直肠癌根治术中的临床应用价值分析

Clinical value of terminal ileal suspension in the treatment of low rectal cancer under laparoscopic radical operation

目的:分析在腹腔镜下低位直肠癌根治术中采用回肠末端悬吊术的临床价值。方法:将2018年2月至2019年4月在信丰县人民医院接受治疗的72例低位直肠癌患者纳入研究,并根据随机数字表法分为对照组和观察组,所有患者均接受低位直肠癌根治术,给予对照组(36例)回肠袢式造口术,给予观察组(36例)回肠末端悬吊术。术后记录两组患者临床相关指标;记录术后两组患者不适症状情况;通过静脉血液检验观察手术前后患者营养指标变化情况;调查术后两组患者并发症情况。结果:观察组术后首次排气时间长于对照组(P<0.05);两组住院时间、住院费用及造口还纳术发生率比较差异无统计学意义(P>0.05)。观察组术后腹泻、造口出血等症状发生率低于对照组,差异有统计学意义(P<0.05);术后两组患者各项营养指标均降低(P<0.05),但两组患者手术前后各项营养指标比较差异无统计学意义(P>0.05)。结论:回肠末端悬吊术应用于腹腔镜下低位直肠癌根治术中,能够有效减少相关术后不适症和并发症,保证身体康复,避免二次全麻手术,减轻患者生理疼痛和医疗成本。

Objective:To analyze the clinical value of terminal ileal suspension in the treatment of low rectal cancer under laparoscopic radical operation.Methods:A total of 72 cases with low rectal cancer were selected in Xinfeng people's hospital,from February 2018 to April 2019,according to the random number table,and these cases were divided into control group and observation group.All of them underwent radical rectal cancer,the control group(36 cases)were given loop stoma of ileum,the observation group(36 cases)were given terminal ileal suspension.The clinically relevant indexes of the two groups were recorded after operation.The discomfort symptoms of the two groups were recorded.The changes of nutritional indexes of the cases before and after the operation were observed by venous blood test.The complications of the two groups were investigated.Results:The first exhaust time in the observation group was longer than that in the control group(P<0.05);There was no significant difference between the two groups in terms of length of stay,cost of hospitalization and the incidence of ostomy(P>0.05).The incidence of postoperative diarrhea,stoma hemorrhage and other symptoms in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05);The nutritional indexes of the two groups were decreased after operation(P<0.05),while there was no significant difference in the nutritional indicators between two groups(P>0.05).Conclusion:Terminal ileal suspension is used in laparoscopic radical resection of rectal cancer,which can effectively reduce postoperative discomfort and complications,ensure physical rehabilitation,avoid secondary anesthesia,and reduce physiological pain and medical costs.