李友西 张建立 闫海龙 王春哓 张佃良.自制滴水双套管持续负压引流技术应用于全胃切除术后的效果评价[J].,2014,14(13):2500-2503 |
自制滴水双套管持续负压引流技术应用于全胃切除术后的效果评价 |
Evaluation of the Effect of Homemade Double PerfusionCannula on Patients with Total Gastrectomy |
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DOI: |
中文关键词: 滴水双套管 负压引流 持续冲洗 全胃切除术 |
英文关键词: Double Perfusion Cannula Negative Pressure Drainage Continuous irrigation Total Gastrectomy |
基金项目:国家自然科学基金项目(90202016) |
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中文摘要: |
目的:目前全胃切除术术后患者腹腔引流多数是放置普通单管引流,然而术后预防性放置滴水双套管的价值还存在争议。
现对滴水双套管应用于全胃切除术后腹腔引流的效果进行系统评价。方法:选取我院2011 年9 月-2013 年9 月开腹全胃切除患
者100 例为研究对象,随机分为实验组和对照组,实验组术毕放置两根滴水双套管,左右各一根,对照组常规放置普通橡胶引流
管两根,比较两组术后退烧药物应用次数,平均每日引流量,腹腔感染发生率,置管时间,术后平均住院时间,严重并发症发生率。
结果:对照组50 例患者中,有1 例出现十二指肠残端瘘合并腹腔出血。1 例切口感染,3 例腹腔积液。实验组50例中,有1 例出现
胃食管吻合口瘘并切口感染。术后前7 天应用退烧药物(体温超过38.5 摄氏度时应用)的平均次数(1.85± 1.10)d,差异有统计学
意义(P<0.05)。平均每日引流量(145.50± 15.45)ml,差异有统计学意义(P<0.05)。平均拔管时间(9.90± 2.75)d,但差异无统计学意
义(P>0.05)。平均术后住院时间(13.98± 2.09)d,差异有统计学意义(P<0.05),吻合口瘘发生率两组无差异。结论:对于全胃切除患
者,术后预防性放置滴水双套管,可明显减轻术后腹腔积液产生的体温升高,缩短住院时间,有效防止腹腔感染的发生,虽不能降
低严重并发症的发生率,但可以起到及时发现及时处理的作用,避免二次手术。值得在临床上推广。 |
英文摘要: |
Objective:At present, the abdominal drainage of postoperative total gastrectomy is mostly used the common drainage
tube. However the prevent usage of double perfusion cannula in patients with total gastrectomy is controversial as its therapeutic value is
uncertain. The aimof the study was to discuss the effect of the use of double perfusion cannula on patients with total gastrectomy.Methods:one hundred patients with gastrectomy who were operated in our hospital from 09/2011 to 09/2013 were divided into the experimental
group and control group. Two double perfusion cannulas were used in the experimental group and two common cannulas in control
group. We compared the use of antipyretic, average drainage per day, incidence of abdominal infection, time of cannula usage, average
length of hospitalization and incidence of severe complications in two groups.Results:In control group, one patient had duodenal stump
leakage and intra-abdominal hemorrhage; one incision infection and three ascites. In experimental group, one patient had stomach1-
esophagus anastomotic leakage and intra-abdominal hemorrhage. The mean time of use of antipyretic in 7 post-operative days was
(1.85± 1.10)d. The mean drainage per day was (145.50± 15.45)ml. The mean length of hospitalization was (13.98± 2.09)d. The above
results had significant differences. But there were no significant differences in the average time of cannulas usage (9.90± 2.75d) and incidence
of anastomotic leakage.Conclusions:The prevent usage of double perfusion cannula in patients with total gastrectomy could relive
the high-temperature caused by ascites, shorten the length of hospitalization, prevent the abdominal infection. The prevent usage of double
perfusion cannula could not decrease the incidence of severe complication, but it can be found and treated on time. Thus the second
operation is avoided and the use of double perfusion cannula should be proposed on the clinic. |
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