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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 575 -578. doi: 10.3877/cma.j.issn.1674-3946.2019.06.011.

所属专题: 文献

论著

腹腔镜直肠癌根治术后指法扩肛对促进胃肠功能早期恢复的临床意义
曹李1, 王麦换1, 田靖波1, 董光龙1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心普通外科
  • 收稿日期:2019-03-21 出版日期:2019-12-26
  • 通信作者: 董光龙

Clinical significance of finger anal dilatation in promoting early recovery of gastrointestinal function after laparoscopic radical resection of rectal cancer

Li Cao1, Maihuan Wang1, Jingbo Tian1, Guanglong Dong1,()   

  1. 1. Department of General Surgery, the First medical center of General Hospital of PLA, Beijing 100853, China
  • Received:2019-03-21 Published:2019-12-26
  • Corresponding author: Guanglong Dong
  • About author:
    Corresponding author: Dong Guanglong, Email:
  • Supported by:
    National Natural Science Foundation of China(No. 81773247); Clinical Research Support Fund of PLA General Hospital(No.2016FC-TSYS-2033)
引用本文:

曹李, 王麦换, 田靖波, 董光龙. 腹腔镜直肠癌根治术后指法扩肛对促进胃肠功能早期恢复的临床意义[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(06): 575-578.

Li Cao, Maihuan Wang, Jingbo Tian, Guanglong Dong. Clinical significance of finger anal dilatation in promoting early recovery of gastrointestinal function after laparoscopic radical resection of rectal cancer[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 575-578.

目的

观察指法扩肛对促进腹腔镜直肠癌根治术后胃肠功能恢复的临床效果。

方法

回顾分析同一手术组2017年1月至2019年1月行腹腔镜下直肠癌手术248例患者资料,根据是否扩肛将患者分为扩肛组和未扩肛组,其中行指法扩肛患者126例,未行扩肛自然排气患者122例,采用SPSS 13.0统计学软件进行分析,两组排气、排便时间及住院天数以均数±标准差表示,独立t检验;吻合口漏采用χ2检验,P<0.05为差异有统计学意义。

结果

在促进肛门排气、排便及降低吻合口漏发生上指法扩肛效果明显,差异有统计学意义(P<0.05)。

结论

指法扩肛可促进腹腔镜直肠癌根治术后肛门早期排气、排便,降低术后吻合口漏发生率,符合当前快速康复外科发展理念,具有一定的临床应用推广价值。

Objective

To observe the clinical outcome of finger anal dilatation in promoting early recovery of gastrointestinal function after laparoscopic radical resection of rectal cancer.

Methods

From January 2017 to January 2019, a retrospective analysis was performed in 248 patients who underwent laparoscopic rectal cancer surgery, including 126 patients underwent fingertip anal dilatation and 122 did not. Statistical analysis was performed by using SPSS13.0 software. Measurement data such as Exhaust time, defecation time and hospital stay were expressed as mean±standard deviation and were examined by independent t test. Count data such as the incidence of anastomotic leakage were described by (n, %) and were examined by chi square test. A P value of <0.05 was considered as statistically significant.

Results

Fingertip anal dilatation was remarkably effective in promoting anal exhaust and defecation and curtailing anastomotic leakage, and the differences were statistically significant(P<0.05).

Conclusion

Finger anal dilatation could promote the early exhaust and defecation of anus and reduce the incidence of anastomotic leakage after laparoscopic rectal cancer resection, in line with the current concept of rapid rehabilitation surgery, and has a certain clinical application and promotion value.

表1 248例行腹腔镜直肠癌根治术后扩肛与否两组患者排气、排便时间比较(±s)
表2 248例行腹腔镜直肠癌根治术后扩肛与否两组住院天数及吻合口漏比较(±s)
[1]
Girard E, Messager M, Sauvanet A, et al.Anastomotic leakage after gastrointestinal sur-gery:Diagnosis and management[J].J Visc Surg,2014,151 (6): 441-450.
[2]
谢亚运,张言言,臧佳,等.直肠癌术后吻合口漏的风险因素评估[J/CD].中华结直肠疾病电子杂志,2019,8(1): 38-41.
[3]
乔天宇,谢磊,王贵玉.直肠癌低位、超低位吻合保肛术后吻合口漏的治疗策略[J/CD].中华结直肠疾病电子杂志,2017,6(6): 510-514.
[4]
姚宏伟,张忠涛.腹腔镜直肠癌根治术的热点与未来发展[J/CD].中华普外科手术学杂志(电子版),2019,13(1): 1-4.
[5]
邓海军,沈智勇,朱煜.腹腔镜直肠癌低位前切除术[J/CD].中华普外科手术学杂志(电子版),2019,13(1): 17-17.
[6]
Chen H, Cai HK, Tang YH. An updated meta-analysis of transanal drainage tube for prevention of anastomotic leak in anterior resection for rectal cancer[J]. Surg Oncol,2018,27(3): 333-340.
[7]
何裕隆.达芬奇机器人辅助低位直肠癌前切除术[J/CD].消化肿瘤杂志(电子版),2018,10(2): 112-114.
[8]
吴凯.低位直肠癌及其腹腔镜手术特殊性与预防性造口的选择[J].中国微创外科杂志,2017,17(9): 832-835.
[9]
Morks AN, Havenga K, Ploeg RJ. Can intraluminal devices prevent or reduce colorectal anastomotic leakage: A review[J]. World J Gastroenterol,2011,17(40): 4461-4469.
[10]
李光明,徐斌,郑丽璇.ANSYS CFX在哈根-泊肃叶方程教学实践中的应用[J].大学物理实验,2016,29(2): 38-40.
[11]
尹淑慧,丁健华,赵玉涓,等.肛管静息压与短暂肛门括约肌松弛的临床研究[J/CD].中华结直肠疾病电子杂志,2016,5(2): 148-152.
[12]
张佳佳,顾宁丹.指法扩肛联合穴位贴敷在颅脑损伤后便秘患者中的应用[J].中西医结合护理(中英文),2017,3(7): 76-79.
[13]
张贵聪,罗光辉.腹腔镜直肠癌手术的常见并发症及其防治措施[J].中国普通外科杂志,2015,24(11): 1613-1617.
[14]
王博林,牛钢,李亚斌.蕈状管预防直肠癌前切除术后吻合口瘘的随机对照研究[J].实用医学杂志,2013,29(7): 1126-1128.
[15]
葛宏升,周军.快速康复外科对结直肠癌患者微创治疗后胃肠功能和应激反应的影响[J/CD].中华普外科手术学杂志(电子版),2018,12(6): 513-516.
[16]
周腾,郑皓,达布·西力特,等.术前经肛间断低负压冲洗引流治疗结直肠癌合并肠梗阻的效果[J].武警医学,2018,29(9): 892-894,900.
[17]
王希,黄建华,罗浩元,等.加速康复外科对腹腔镜辅助结直肠癌根治术后患者免疫功能及近期结局的影响[J].腹腔镜外科杂志,2016,21(11): 837-841.
[18]
Yagyu T, Yamamoto T, Mochizuki H.Regular Finger Dilation for Preventing Anastomotic Stenosis After Low Anterior Resection[J]. Surg Today,2002,32(3): 220-223.
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