中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
18期
3236-3239
,共4页
Crohn病%肠段切除%吻合口瘘%吻合
Crohn病%腸段切除%吻閤口瘺%吻閤
Crohn병%장단절제%문합구루%문합
Crohn disease%Bowel resection%Anastomotic leakage%Anastomosis
目的:探讨克罗恩病(CD)患者肠切除+肠吻合术不同的吻合方式对CD术后吻合口瘘的影响。方法回顾性分析2000年12月至2013年12月在解放军第八五医院行肠切除肠吻合术的CD患者42例的临床资料,比较实施侧侧吻合(SSA组,22例)与端侧或端端吻合(非SSA组,20例)两组患者的术后吻合口瘘发生情况。结果两组患者的年龄、性别、吸烟史及术前存在脓肿或瘘管情况无统计学差异(P>0.05)。术后非SSA组有30.0%(6/20)发生了不同程度的吻合口瘘,而SSA组仅有4.5%(1/22)发生了吻合口瘘(P<0.05);吻合口瘘外手术相关并发症发生率在两组无明显差异,分别为13.6%(3/20)和15.0%(3/22)(P=0.15);术后平均住院时间在非SSA组和SSA组分别为12.3 d和9.7 d(P<0.05),SSA组明显缩短。结论相比较于端端吻合与端侧吻合,侧侧吻合方式吻合口瘘的发生率明显降低,优点明显,可考虑作为CD肠切除后首选的吻合方式。
目的:探討剋囉恩病(CD)患者腸切除+腸吻閤術不同的吻閤方式對CD術後吻閤口瘺的影響。方法迴顧性分析2000年12月至2013年12月在解放軍第八五醫院行腸切除腸吻閤術的CD患者42例的臨床資料,比較實施側側吻閤(SSA組,22例)與耑側或耑耑吻閤(非SSA組,20例)兩組患者的術後吻閤口瘺髮生情況。結果兩組患者的年齡、性彆、吸煙史及術前存在膿腫或瘺管情況無統計學差異(P>0.05)。術後非SSA組有30.0%(6/20)髮生瞭不同程度的吻閤口瘺,而SSA組僅有4.5%(1/22)髮生瞭吻閤口瘺(P<0.05);吻閤口瘺外手術相關併髮癥髮生率在兩組無明顯差異,分彆為13.6%(3/20)和15.0%(3/22)(P=0.15);術後平均住院時間在非SSA組和SSA組分彆為12.3 d和9.7 d(P<0.05),SSA組明顯縮短。結論相比較于耑耑吻閤與耑側吻閤,側側吻閤方式吻閤口瘺的髮生率明顯降低,優點明顯,可攷慮作為CD腸切除後首選的吻閤方式。
목적:탐토극라은병(CD)환자장절제+장문합술불동적문합방식대CD술후문합구루적영향。방법회고성분석2000년12월지2013년12월재해방군제팔오의원행장절제장문합술적CD환자42례적림상자료,비교실시측측문합(SSA조,22례)여단측혹단단문합(비SSA조,20례)량조환자적술후문합구루발생정황。결과량조환자적년령、성별、흡연사급술전존재농종혹루관정황무통계학차이(P>0.05)。술후비SSA조유30.0%(6/20)발생료불동정도적문합구루,이SSA조부유4.5%(1/22)발생료문합구루(P<0.05);문합구루외수술상관병발증발생솔재량조무명현차이,분별위13.6%(3/20)화15.0%(3/22)(P=0.15);술후평균주원시간재비SSA조화SSA조분별위12.3 d화9.7 d(P<0.05),SSA조명현축단。결론상비교우단단문합여단측문합,측측문합방식문합구루적발생솔명현강저,우점명현,가고필작위CD장절제후수선적문합방식。
Objective To determine whether different anastomosis is associated with anastomotic leakage after bowel resection for Crohn disease (CD). Methods A retrospective analysis was carried out of patients who underwent bowel resection for CD at The 85th Hospital of the PLA from 2000 to 2013. Anastomotic fistula in patients with SSA was compared with that in patients with non-SSA. Results The age, sex, smoking history and preoperative abscess or fistula had no significant difference between the SSA and non-SSA (P>0.05). The postoperative anastomotic leakage rate was 30.0%(6/20) in the non-SSA group, and was only 4.5%(1/22) in the SSA group (P<0.05). Significant difference was found between the two group of non-anastomotic fistula complication rate (P<0.05). Mean postoperative hospital stay of the SSA group was significantly shorter. Conclusion SSA is associated with decreased anastomotic fistula as compared to non-SSA.