损伤控制理念在肠癌术后肠瘘中的应用

The application of damage control concept in colon bowel fistula

目的:探讨损伤控制理念在肠癌术后肠瘘中的应用。方法:对照组给予常规性治疗,观察组应用损伤控制理念,对比分析两组患者干预前后疼痛及生活质量改善情况。结果:观察组瘘口吻合时间、换药次数、回收肠瘘液量、下床活动时间、平均住院时间均少于对照组,而术后疼痛评分低于对照组,满意度评分高于对照,差异有统计学意义(P<0.05)。观察组术后3 d、术后7 d血清蛋白水平显著高于对照组(P<0.05)。观察组造口感染率、泌尿系统感染、肺炎、高血清淀粉酶发生率显著低于对照组(P<0.05)。结论:损伤控制理念能有效促进结肠癌术后肠瘘患者围手术期患者术后康复,减轻患者手术创伤,改善患者术后免疫功能,降低术后并发症的发生率。

Objective:To discuss the application of damage control concept in colon bowel fistula.Methods:The control group received conventional treatment,and the observation group received damage control theory.We analyzed two groups of patients before and after intervention the pain and improvement in quality of life.Results:The observation group fistula anastomosis time, frequency of dressing change,the amount of fluid recovered intestinal fistula,ambulation time,the average length of stay were less than the control group;the postoperative pain scores were lower than the control group;the satisfaction scores were higher than the control group;there was statistically significant(P<0.05).The patients in the observation group 3 d,7 d after operation the serum protein level was significantly higher than that of the control group(P<0.05).The observation group stoma infection,urinary tract infections,pneumonia,high serum amylase were significantly lower than the control group(P<0.05).Conclusion:Damage control concept can effectively promote rehabilitation of fistula patients after colon cancer surgery,reduce the surgical trauma,improve immune function after surgery,and reduce the incidence of postoperative complications.