周轶冰

【摘要】 目的：肛管持续冲洗+负压引流在预防低位直肠癌术后吻合口瘘中的应用研究。方法：选取2015年7月-2018年3月本院经肠镜取病理确诊为低位直肠癌且行Dixon手术治疗的患者56例，按照随机数字表法分为研究组与对照组，各28例。研究组术后采用肛管持续冲洗+负压引流的方法进行处置，对照组术后采用肛管引流的方法进行处置。比较两组手术时间、术中出血量、术后首次排气时间、住院时间、住院费用、术后感染及吻合口瘘发生率。结果：两组手术时间、术中出血量、术后首次排气时间、住院时间和住院费用比较，差异均无统计学意义（P>0.05）。研究组术后感染率、出现吻合口瘘率均明显低于对照组，差异均有统计学意义（P<0.05）。结论：肛管持续冲洗+负压引流能够有效地预防低位直肠癌术后吻合口瘘的发生。

【关键词】 肛管持续冲洗； 负压引流； 低位直肠癌； 吻合口瘘

【Abstract】 Objective：To explore the application of continuous anal irrigation and negative pressure drainage in preventing anastomotic leak after low rectal cancer operation.Method：A total of 56 cases were diagnosed low rectal cancer and operated by Dixon surgery in our hospital from July 2015 to March 2018，they were divided into experimental group and control group according to table of random numbers，28 cases in each group.The experimental group was given continuous anal irrigation and negative pressure drainage after operation，the control group was received anal canal drainage.The operation time，intraoperative blood loss，postoperative first exhaust time，hospitalization time，hospitalization expenses，the incidence rate of postoperative infection and anastomotic leak of two groups were compared.Result：There were no significant difference in the operative time，intraoperative blood loss，postoperative first exhaust time，hospitalization time and hospitalization expenses between two groups（P>0.05）.The incidence rate of postoperative infection and anastomotic leak in the experimental group were lower than those in the control group，the differences were statistically significant（P<0.05）.Conclusion：The continuous anal irrigation and negative pressure drainage can effectively prevent the occurrence of anastomotic leak after low rectal cancer operation.

【Key words】 Continuous anal irrigation； Negative pressure drainage； Low rectal cancer； Anastomotic leak

First-authors address：Jiamusi Center Hospital，Jiamusi 154002，China

doi：10.3969/j.issn.1674-4985.2018.18.029

直腸癌在我国是一种恶性程度较高的消化道肿瘤，其中低位直肠癌最为常见，普遍以根治性直肠前切除术（Dixon）和腹会阴联合直肠癌根治术（Miles）为主要的手术治疗手段。随着技术的不断发展和患者对术后生活质量要求的不断提高，即使是低位或超低位直肠癌也可以采用保肛手术进行治疗，直肠癌保肛手术已经得到了广泛认可，但由于术后吻合口缺血、张力过大，经常发生吻合口瘘，这就导致肠内容物漏至腹腔，引起腹腔感染，至感染性休克，严重者并发多器官功能衰竭，危及患者生命[1-3]。

本研究对研究组患者术后采用肛管持续冲洗+负压引流的方法进行处置，对照组患者术后采用肛管引流的方法进行处置，探讨肛管持续冲洗+负压引流在预防低位直肠癌术后吻合口瘘中的应用研究，现报道如下。