目的 探讨应用三管引流法在防治直肠癌前切除术后吻合口漏中的疗效。方法 选取在我科2018年4月—2020年3月接受腹腔镜或者开腹直肠癌前切除术患者186例,将患者随机分为两组,研究组(三管引流法)96例,对照组(常规引流法)90例,进行对比研究。比较两组患者术后吻合口漏及恢复情况。结果 研究组患者吻合口漏发生率、非计划手术率、回肠造口率低于对照组(P＜0.05),吻合口漏患者中,研究组体温恢复正常时间、C反应蛋白(CRP)恢复正常时间及住院时间均少于对照组,差异均有统计学意义(P＜0.05)。结论 应用三管引流法,可预防直肠癌前切除术后吻合口漏,通过非手术治疗避免非计划二次手术,缩短吻合口漏患者恢复时间,显示更好的临床疗效。

Objective To explore and evaluate the clinical application value of three-tube drainage for the treatment of anastomotic leakage after low anterior resection for rectal cancer. Methods We retrospectively analyzed a total of 186 rectal cancer patients after low anterior resection for rectal cancer in our hospital from April 2018 to March 2020. According to the difference of prevention to anastomotic leakage, these patients were divided into two groups randomly that 90 cases used conventional drainage as control group, and 96 cases used three-tube drainage as study group. Postoperative recovery and anastomotic leakage were compared between these two groups. Results The rate of anastomotic leakage, ileostomy and unplanned reoperation of study group were lower than those of control group (P＜0.05).The times returned to normal of body temperature and C-reactive protein (CRP), the average length of stay in hospital of study group were shorter than those of control group respectively (P＜0.05). Conclusion The application of three-tube drainage may prevent anastomotic leakage and unplanned reoperation after low anterior resection for rectal cancer and shorten postoperative recovery time, to reveal better clinical effects.

目的 分析加速康复外科措施在行腹腔镜辅助结直肠癌根治术治疗患者中的应用价值。方法 2017年6月—2018年8月,选取74例行腹腔镜辅助结直肠癌根治术患者进行研究,按照随机数字表法分为观察组、对照组,对照组实施常规康复外科措施,观察组实施加速康复外科措施,对比两组术后恢复情况、住院情况、应激反应及营养状态。结果 观察组术后首次排气时间、下床活动时间、早期进食时间及导管拔出时间短于对照组(P＜0.05);观察组住院时间、总住院费用少于对照组(P＜0.05);术前两组患者Hs-CRP(超敏C-反应蛋白)、ALB(白蛋白)、PA(前白蛋白)及Hb(血红蛋白)指标比较,差异无统计学意义(P＞0.05)。术后第3 d,观察组Hs-CRP、ALB、PA及Hb指标均优于对照组(P＜0.05)。结论 加速康复外科措施在腹腔镜辅助结直肠癌根治术患者中的开展价值显著。

Objective To analyze the value of accelerated rehabilitation surgery in the treatment of patients undergoing laparoscopic assisted radical resection of colorectal cancer. Methods From June 2017 to August 2018, 74 patients who underwent laparoscopic assisted radical resection of colorectal cancer were enrolled in the study. The patients were divided into observation group and control group according to the random number table method. The group implemented accelerated rehabilitation surgery measures to compare postoperative recovery, hospitalization, and immune function. Results The first exhaust time, the time of getting out of bed, the time of early feeding and the time of catheter extraction were shorter in the observation group than that in the control group(P<0.05). The hospitalization time and total hospitalization cost in the observation group were less than those in the control group(P<0.05). There were no significant differences in Hs-CRP(high-sensitivity C-reactive protein), ALB(albumin), PA(pre-albumin) and Hb(hemoglobin) between the two groups before surgery(P>0.05). On the 3rd day after operation, the indexes of Hs-CRP, ALB, PA and Hb in the observation group were better than those in the control group(P<0.05). Conclusion Accelerated rehabilitation surgery is of great value in the development of laparoscopic assisted colorectal cancer radical surgery.