CAJ | 학술논문

目的探讨术前血管造影及术中多普勒血流探测在结肠代食管术中的应用价值.方法选择37例行结肠代食管术患者,行结肠代食管常规术式17例(常规组);术前行肠系膜上、下动脉血管造影,术中行多普勒血管超声检测20例(改良组),观察两组临床疗效.结果常规组术后6～15d出现吻合口瘘4例,手术时间(367.0±53.3) min;改良组术后7d出现吻合口瘘1例,手术时间(302.0±67.1) min,两组手术时间比较差异有统计学意义(P＜0.05).结论结肠代食管术前血管造影及术中进行移植结肠段的多普勒血流探测,可实时直观地显示移植结肠段血管形态学表现,观察肠系膜血管的走行方向及分布范围,为移植结肠段血管提供准确可靠的评价,指导最佳移植结肠段的选择,在一定程度上降低了术后并发症的发生.
목적 탐토술전혈관조영급술중다보륵혈류탐측재결장대식관술중적응용개치.방법 선택37례행결장대식관술환자,행결장대식관상규술식17례(상규조);술전행장계막상、하동맥혈관조영,술중행다보륵혈관초성검측20례(개량조),관찰량조림상료효.결과 상규조술후6～15d출현문합구루4례,수술시간(367.0±53.3) min;개량조술후7d출현문합구루1례,수술시간(302.0±67.1) min,량조수술시간비교차이유통계학의의(P＜0.05).결론 결장대식관술전혈관조영급술중진행이식결장단적다보륵혈류탐측,가실시직관지현시이식결장단혈관형태학표현,관찰장계막혈관적주행방향급분포범위,위이식결장단혈관제공준학가고적평개,지도최가이식결장단적선택,재일정정도상강저료술후병발증적발생.
Objective To investigate the effect of preoperative angiography and intraoperative Doppler blood flow detection in the surgery of colonic interposition for esophageal.Methods Thirty-seven patients who underwent the surgery of colonic interposition for esophageal were chosen,17 cases received colonic interposition for esophageal routine operation (routine group),and 20 cases received preoperative angiography of superior and inferior mesenteric arteries and intraoperative Doppler blood flow detection (improved group),the clinical efficacy was observed.Results Routine group occurred anastomotic leak in 4 cases on postoperative 6-15 d,operation time was (367.0 ± 53.3) min,and improved group occurred anastomotic leak in 1 case on postoperative 7 d,operation time was (302.0 ± 67.1) min,the operation time between two groups had significant difference (P ＜ 0.05).Conclusions The adoption of preoperative angiography and intraoperative Doppler blood flow detection can real-time directly display the vascular morphology of transplanted colon segment,observe the traveling direction and distribution of mesenteric arteries,provide accurate and rehable evaluation of blood vessel of transplanted colon,which can conduct to the optimum selection of transplanted colon and reduce the incidence of postoperative complications.