自制吻合环复合装置对直肠癌患者术中保护回肠造口及预后的影响

Effect of Self-made Anastomotic Ring Complex Device on Postoperative Ileostomy Protection and Prognosis in Patients with Rectal Cancer

目的:探讨自制吻合环复合装置对直肠癌患者术中保护回肠造口的影响,并分析预后情况。方法:选取2018年7月—2021年9月佳木斯市中心医院收治的67例行直肠癌手术的患者作为研究对象,采用随机掷骰子法分为对照组(33例)、观察组(34例)。对照组行传统回肠造口术,观察组采用自制吻合环复合装置行回肠造口术,对比两组患者临床指标,造口皮肤情况,生活质量评分,术后并发症发生率,分析术后还纳情况。结果:观察组造口操作、手术时间明显更长,住院时间更短,差异有统计学意义(t=3.261、2.353、2.762,P<0.05);术后,与对照组比较,观察组各评分明显更高,差异有统计学意义(t=23.187、4.286;11.384、6.620;8.484、6.380,P<0.05);术后,与对照组比较,观察组生活质量各评分明显更高,差异有统计学意义(t=0.637、4.360;0.411、5.380;0.067、5.224;0.378、5.930,P<0.05);与对照组比较,观察组术后并发症发生率更低,差异有统计学意义(χ^(2)=5.583,P<0.05);持续对患者随访6个月,对照组33例患者无失访病例。术后3个月,还纳者12例,占比36.36%;术后6个月,还纳者20例,占比60.61%,未还纳者1例,占比3.03%。还纳者平均住院时间(6.71±2.12)d。结论:在直肠癌手术中应用自制吻合环复合装置,可保证手术成功率,保护患者的回肠造口,且术后并发症发生较少,还可提高患者生活质量。

Objective:To investigate the effect of a homemade anastomotic ring composite device on intraoperative protection of the ileostomy in patients with rectal cancer and to analyze the prognosis.Methods:67 patients admitted to the hospital for rectal cancer surgery from July 2018 to September 2021 were selected as study subjects and were divided into control group(33 cases)and observation group(34 cases)using the random dice rolling method.The control group underwent conventional ileostomy and the observation group underwent ileostomy using a homemade anastomotic ring composite device.The clinical indicators,stoma skin condition,quality of life scores,postoperative complication rates and postoperative return were compared between the two groups.Results:The observation group had significantly longer stoma operation and surgery time and shorter hospital stay,with statistically significant differences(t=3.261,2.353,2.762,P<0.05).After surgery,each score was significantly higher in the observation group compared with the control group,with statistically significant differences(t=23.187,4.286;11.384,6.620;8.484,6.380,P<0.05).After surgery,each quality of life score was significantly higher in the observation group compared with the control group,with statistically significant differences(t=0.637,4.360;0.411,5.380;0.067,5.224;0.378,5.930,P<0.05).Compared with the control group,the postoperative complication rate was lower in the observation group,and the difference was statistically significant(χ^(2)=5.583,P<0.05).The patients were continuously followed up for 6 months,and there were no lost cases in the control group of 33 patients.At 3 months postoperatively,12 patients(36.36%)were returned,at 6 months postoperatively,20 patients(60.61%)were returned,and 1 patient(3.03%)was not returned.The duration of hospitalization for those who returned was(6.71±2.12)d.Conclusion:The application of homemade anastomotic ring composite device in rectal cancer surgery can ensure the success rate of surgery,protect the patients’ileostomy,and have fewer postoperative complications,and also improve the quality of life of patients.