CAJ | 학술논문

目的总结直肠癌手术骶前分离中预防大出血的临床经验.方法回顾2000至2006年间我院所行的345例低位直肠癌手术,将使用全直肠系膜切除(TME)原则进行骶前分离的150例患者设为A组,将使用传统骶前分离的195例患者设为B组,两组病人术中出血量、术后引流管引流量及引流管的拔除时间做分组对照研究.结果 A组无一例发生骶前大出血,而且术中出血量、术后引流管引流量明显少于B组,差异有统计学意义.B组发生骶前大出血5例,占1.45%,使用图钉加明胶海绵按压止血成功3例,死亡1例.结论全直肠系膜切除术是预防盆腔大出血的有效措施.
목적 총결직장암수술저전분리중예방대출혈적림상경험.방법 회고2000지2006년간아원소행적345례저위직장암수술,장사용전직장계막절제(TME)원칙진행저전분리적150례환자설위A조,장사용전통저전분리적195례환자설위B조,량조병인술중출혈량、술후인류관인류량급인류관적발제시간주분조대조연구.결과 A조무일례발생저전대출혈,이차술중출혈량、술후인류관인류량명현소우B조,차이유통계학의의.B조발생저전대출혈5례,점1.45%,사용도정가명효해면안압지혈성공3례,사망1례.결론 전직장계막절제술시예방분강대출혈적유효조시.
Objective To summarize the experience of clinical management of massive pelvic hemorrhage in the Mile' s operation for the rectal carcinoma. Methods A review study was completed for 345 cases from 2000 to 2006, including 150 cases with the TME principles as group A and 195 cases with the traditional separation as group B. Patients blood less,pestoperative drainage tube drainage, and the drainage tube for the control group except the time were compared between group A and group B. Results Five cases pelvic hemorrhage (1.45%) occurred in group B,four cases of massive pelvic hemorrhage were successfully managed by the press with thumbtacks. One case of death. None pelvic hemorrhage occurred in group A, and blood loss, postoperative drainage tube drainage was less than that in group B,with statistical significance. Conclusion Radical resection with total mesentery excision is effective for prevention of massive pelvic hemorrhage.