改良脉冲冲洗仪在腹腔镜下直肠肿瘤手术中的应用

Application of modified pulse flushing instrument in laparoscopic rectal tumor surgery

目的 观察改良脉冲冲洗仪在腹腔镜下直肠肿瘤手术中的冲洗效果。方法 行腹腔镜下直肠肿瘤手术的100例患者分为两组;试验组(50例)应用改良脉冲冲洗进行腹腔同步冲洗,对照组(50例)采用传统方法腹腔冲洗,单管连接负压吸引器吸引。比较两组患者创面肿瘤脱落细胞阳性率、切口愈合情况、术后引流液转变情况、肠道通气时间、术后1、3 d血CRP水平、术后1、2 d体温、高热发生率、手术时间及术后医生满意度。结果 试验组创面肿瘤脱落细胞阳性率、术后1、2 d体温低于对照组(P<0.05),引流液转为淡黄色时间、引流管拔除时间、手术时间短于对照组(P<0.05),医生满意度高于对照组(P<0.05)。两组切口甲级愈合比例、肛门排气时间、术后1、3 d血CRP水平、高热发生率比较均无统计学差异(P>0.05)。结论 采用改良脉冲冲洗仪行腹腔镜下直肠肿瘤手术中腹腔冲洗安全、有效,能降低并发症的发生。

Objective To observe the irrigating efficacy of modified pulse flushing instrument in laparoscopic rectal tumor surgery.Methods A total of 100 patients undergoing laparoscopic rectal tumor surgery were divided into two groups with 50 cases each.Group A was treated with modified pulse flushing for simultaneous abdominal wash, and group C was treated with traditional abdominal irrigation followed by single tube negative pressure aspirating.The positive rate of residual cells on the wound surface, wound healing, postoperative drainage fluid transformation, anal exhaust time, blood CRP level on the 1^(st) and 3^(rd) day after operation, body temperature on the 1;and 2;day after operation, incidence of high fever, operation time and postoperative doctor satisfaction were compared between the two groups.Results The positive rate of residual cells on the wound surface and body temperature on the 1^(st) and 2^(rd) day after operation were lower, the time for drainage fluid color changed to light yellow, the time of postoperative drainage tube removal and the operation time were shorter, and postoperative doctor satisfaction was higher in group A than those in group C(P<0.05).There were no significant differences in the proportion of grade A wound healing, anal exhaust time, blood CRP level on the 1^(st) and 3^(rd) day after operation and incidence of high fever between the two groups(P>0.05).Conclusion The use of modified pulse flushing instrument for simultaneous abdominal wash is safe and effective with a decrease of the complications.