摘要
目的:比较结直肠癌经自然腔道取标本手术(NOSES)使用聚维酮碘加压保留灌肠冲洗与普通冲洗两种方式对细菌负荷及术后短期并发症的影响。方法:前瞻性分析49例符合纳入标准的结直肠癌患者,随机分为保留灌肠冲洗组(26例)和普通冲洗组(23例),比较两组患者术中肠腔和腹腔的细菌学负荷以及术后炎症指标和短期并发症。结果:加压保留灌肠组患者的肠腔细菌数明显少于普通冲洗组,差异有统计学意义(P<0.05)。加压保留灌肠组患者术后第1天及第4天血清降钙素原、第1天C反应蛋白指标低于普通冲洗组,差异有统计学意义(P<0.05)。加压保留灌肠冲洗(OR:0.22,95%CI:0.06~0.85,P=0.028)是降低患者术后短期并发症的发生率及严重程度的保护性因素。结论:聚维酮碘加压保留灌肠是一种有效的冲洗方式,可显著降低术中细菌负荷、减轻术后炎症反应、改善近期临床结局。
Objective:To compare the effects of povidone-iodine pressurized retention en-ema irrigation and ordinary irrigation on bacterial load and postoperative complications in natural ori-fice specimen extraction surgery for colorectal cancer.Method:A total of 49 eligible colorectal cancer patients were prospectively analyzed,with 26 patients randomly assigned to the pressure retention enema group and 23 patients assigned to the ordinary irrigation group.Bacteriological load during surgery,postoperative inflammatory indexes,and short-term complications were compared between the two groups.Result:The pressure retention enema group exhibited significantly lower levels of intestinal bacteria compared to the ordinary irrigation group,with a statistically sig-nificant difference(P<0.05).Additionally,the pressure retention enema group had lower serum pro-calcitonin and C-reactive protein levels on the 1st and 4th days after surgery,compared to the ordi-nary irrigation group,with a statistically significant difference(P<0.05).Pressurized retention enema irrigation(OR:0.22,95%CI:0.06-0.85,P=0.028)was identified as a protective factor in reducing the incidence and severity of short-term postoperative complications.Conclusion:Povidone-iodine pressurized retention enema is an effective irrigation method that significantly reduces bacterial load during surgery,minimizes postoperative inflammatory reaction,and improves short-term clini-cal outcomes.
作者
李沛骋
李龙
王新建
LI Pei-cheng;LI Long;WANG Xin-jian(Jinzhou Medical University Weihai Central Hospital Postgraduate Training Base,Weihai 264200,China;Department of Gastrointestinal Surgery,Weihai Central Hospital,Weihai 264200,China)
出处
《中国现代普通外科进展》
CAS
2024年第10期773-778,共6页
Chinese Journal of Current Advances in General Surgery
关键词
结直肠肿瘤
经自然通道取标本手术
细菌学
Colorectal tumor
Natural orifice specimen extraction surgery
Bacteriology