结肠J型贮袋吻合及结肠横行贮袋吻合应用于直肠癌骶前切除术临床对比.doc

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1、结肠J型贮袋吻合及结肠横行贮袋吻合应用于直肠癌紙前切除术临床对比［摘要］目的探讨结肠J型贮袋吻合与结肠横行贮袋吻合应用于直肠癌紙前切除术的临床对比效果。方法120例直肠癌患者根据手术方法的不同分为治疗组与对照组各60例,两组首先都釆用直肠癌紙前切除术，然后对照组采用结肠J形贮袋吻合，治疗组采用结肠横行贮袋吻合。记录两组平均手术时间、术中输血量、住院时间、并发症发生情况及出现直肠抑制反射的几率。结果治疗组的平均手术时间、术中输血量和住院时间均明显少于对照组(P0.05)。术后6个月，治疗组出现直肠抑制反射的几率明显高于对照组(P<0.05)。结论结肠横行贮袋吻合应用直肠癌紙前切除术能有效减少创伤

2、，促进创伤恢复，同时促进术后肛门直肠功能的恢复。［关键词］结肠J型贮袋吻合；结肠横行贮袋吻合；直肠癌紙前切除术；肛门［中图分类号］R735.37［文献标识码］C［文章编号］1673-7210(2012)07(b)-0147-03TheclinicalcontrastbetweencolonicJpouchanastomosisandtransversecolonicpouchanastomosisfortherectalsacralanteriorresectionTONGQiangDepartmentofGeneralSurgery,PukouHospitalinNanjingCity,Ji

3、angsuProvince,Nanjing210031,China[Abstract]ObjectiveToinvestigatetheclinicalcontrasteffectsofcolonicJpouchanastomosisandtransversecolonicpouchanastomosisfortherectalsacralanteriorresectiori.Methods120patientswithrectalcancerwereequallydividedintothetreatmentgroupandthecontrolgroupaccordingtodifferen

4、tsurgicaltechniques,eachgrouphad60cases,allcasesfirstlyweregivenrectalsacralanteriorresection,andthenthecontrolgroupweregivenwithcolonicJ-pouchanastomosisandthetreatmentgroupweregivenwithcolontransversepouchanastomosis・Themeantimeofoperation,intraoperativebloodtransfusion,hospitalizationtime,thecomp

5、licationandtheriskofrectaiinhibitoryreflexwereobservedandcompared・ResultsThemeantimeofoperation,intraoperativebloodtransfusionandhospitalizationtimeofthetreatmentgroupweresignificantlylessthanthecontrolgroup(P<0.05).Thecomplicationcontrastbetweenthetwogroupshadnosignificantdifference(P<0・05)・After6m

6、onths,theriskofrectalinhibitoryreflexoftreatmentgroupwassignificantlyhigherthancontrolgroup(P<0.05).ConclusionComparedwithcolonicJpouchsurgery,colontransversepouchanastomosisforrectaicancersacralanteriorresectioncaneffectivelyreducethetrauma,promotetherecoveryofpostoperativeanorectaifuncticm.[Keywor

7、ds]ColonicJpouchanastomosis；Transversecolonicpouch；Rectalsacralanteriorresection；Anal直肠癌是威胁人类健康的主要癌症之一，在我国城市试点地区已居全部恶性肿瘤的第4位，并有逐年上升的趋势。据WHO的报告，我国直肠癌死亡率2005年比1991年增加了70.7%,年均增加4.7%。直肠癌的化学与放射治疗多用于直肠癌手术前