不同骶前冲洗引流装置在直肠癌术患者并发症中临床应用

亓德美　付霞　郑珊红　付晓云

【摘要】 目的：对比自制会阴骶前冲洗引流器与单腔引流器在低位直肠癌术后骶前腔引流过程中的临床疗效。方法：选取2012年7月-2017年7月在本院就诊的82例直肠癌患者，遵循自愿的原则按入院时间随机分为对照组（单腔引流器）和观察组（自制会阴骶前冲洗引流器），每组各41例。对比两组引流管拔管时间、住院时间等术后恢复情况指标和术后吻合口瘘等并发症发生情况。结果：观察组引流管拔管时间和住院时间情况均明显优于对照组，差异均有统计学意义（P<0.05）。观察组术后并发症发生率明显低于对照组，差异有统计学意义（P<0.05）。结论：低位直肠癌术后患者应用自制会阴骶前冲洗引流器进行骶前腔的间断冲洗引流，能缩短引流管拔管时间和患者住院时间，更有利于减少术后吻合口瘘等并发症的发生，有效提高患者术后生活质量。

【关键词】 低位直肠癌; 骶前腔冲洗引流; 自制会阴骶前冲洗引流器; 单腔引流器

【Abstract】 Objective：To compare the clinical efficacy of self-made perineal presacral irrigation drainage device and single lumen drainage device in the anterior sacral drainage after low rectal cancer operation.

Method：82 cases of low rectal cancer operation were selected in our hospital from July 2012 to July 2017 and randomly divided into observation group（self-made perineal presacral irrigation drainage device）and control group（single lumen drainage device），41 cases in each group.The postoperative recovery indexes such as extubation time and hospitalization time of the drainage tube and the postoperative anastomotic leakage were compared between the two groups.Result：The extubation time of the drainage tube and hospitalization time in the observation group were significantly better than those in the control group（P<0.05）.The incidence of postoperative complications in the observation group was significantly lower than that in the control group（P<0.05）.Conclusion：In patients with low rectal cancer，the application of Self-made perineal presacral irrigation drainage device for intermittent lavage drainage of the anterior sacral can shorten extubation time of the drainage tube and hospitalization time，and it is more conducive to reduce complications such as postoperative anastomotic leakage ，reducing hospitalization costs and effectively improving the quality of life after surgery.

【Key words】 Low rectal cancer; Presacral irrigation drainage; Self-made perineal presacral irrigation drainage device; Single lumen drainage device

First-authors address：Taian Cancer Prevention and Treatment Hospital，Taian 271000，China

doi：10.3969/j.issn.1674-4985.2019.13.013

直腸癌是消化道最常见的恶性肿瘤之一，其发病率和死亡率逐年上升，严重威胁着人们的生命、发病年龄以30～60岁居多[1]。由于直肠癌位于盆腔深处，解剖关系复杂，直肠癌手术对盆腔有很大的创伤，形成一个巨大的骶前空间，有出血和渗出液体[2]。骶前引流冲洗是否彻底、有效和充分将直接影响直肠癌患者术后并发症的发生率。因此，选择合适的引流装置以达到最佳的引流效果和满意的临床效果非常重要。本研究使用一种自行设计的会阴骶前冲洗引流器（专利号：ZL200820023698.9）用于低位直肠癌患者术后冲洗引流，对本院近5年来行低位直肠癌Dixon或Miles术的82例患者进行总结分析，以探讨Dixon或Miles手术后自行设计的骶前冲洗引流器的冲洗引流效果。现报道如下。

1 资料与方法