双套管引流+肛门直肠双套管持续低压冲洗在中低位直肠癌术后患者吻合口瘘防控中的成本-效果比较

Cost-effectiveness comparison of double cannula drainage+anorectal double cannula continuous low-pressure irrigation in the prevention and control of anastomotic leakage in patients with middle and low rectal cancer surgery

目的:分析双套管引流+肛门直肠双套管持续低压冲洗在中低位直肠癌术后患者吻合口瘘防控中的成本-效果。方法:选取我院2020年2月~2021年2月期间收治的中低位直肠癌患者96例作为研究对象,均行腹腔镜辅助下肿瘤前切除术,依据随机数字表法分为2组,每组48例。对照组行传统腹腔引流,研究组行双套管引流+肛门直肠双套管持续低压冲洗,统计康复指标(引流管内置时间、住院时间、住院费用)、吻合口瘘发生率、吻合口瘘有关并发症发生率、其他并发症发生率。结果:两组吻合口瘘发生率对比,无明显差异(P>0.05)。研究组住院时间、引流管放置时间、住院费用少于对照组(P<0.05)。研究组吻合口瘘有关并发症发生率6.25%低于对照组25.00%(P<0.05)。研究组二次手术率0.00%低于对照组16.67%,术后6个月吻合口狭窄率0.00%低于对照组18.75%(P<0.05)。研究组其他并发症发生率2.08%低于对照组18.75%(P<0.05)。结论:双套管引流+肛门直肠双套管持续低压冲洗在中低位直肠癌术后患者具有预防吻合口瘘效果,且能减少医疗成本,缩短住院时间与引流管放置时间,并增加安全性。

Objective:To analyze the cost-effectiveness of double cannula drainage+anorectal double cannula continuous low-pressure irrigation in the prevention and control of anastomotic leakage in patients with middle and low rectal cancer postoperatively.Methods:A total of 96 patients with middle and low rectal cancer admitted to our hospital from February 2020 to February 2021 were selected as the study subjects.All patients underwent laparoscopic pre-tumor resection and were divided into 2 groups according to random number table method,with 48 patients in each group.The control group received traditional abdominal drainage,and the research group received double cannula drainage+anorectal double cannula continuous low-pressure irrigation.The recovery indicators(drainage tube placement time,length of stay,hospitalization cost),incidence of anastomotic fistula,incidence of anastomotic fistula-related complications,and incidence of other complications were analyzed.Results:There was no significant difference in the incidence of anastomotic leakage between the two groups(P>0.05).The hospitalization time,drainage tube placement time,and hospitalization costs in the study group were less than those in the control group(P<0.05).The incidence rate of anastomotic leakage related complications in the study group was 6.25%lower than that of the control group(25.00%)(P<0.05).The secondary operation rate of the study group was 0.00%lower than that of the control group,16.67%,and the anastomotic stenosis rate 6 months after surgery(0.00%)was lower than that of the control group(18.75%)(P<0.05).The incidence of other complications in the study group(2.08%)was lower than that in the control group(18.75%)(P<0.05).Conclusion:Double cannula drainage+anorectal double cannula continuous low pressure irrigation can prevent anastomotic leakage in patients with middle and low rectal cancer after surgery,and can reduce medical costs,hospitalization time and drainage.Tube placement time and increased safety.