季恩敏,张军,李昌权,李岗,史伟,于浩,李光云,田景中
JI Enmin,ZHANG Jun,LI Changquan,LI Gang,SHI Wei,YU Hao,LI Guangyun,TIAN Jingzhong

• 1:安徽省亳州市人民医院胃肠外科

摘要(Abstract)：

目的:探讨不同肠系膜下动脉(IMA)结扎部位对直肠癌手术患者的效果。方法:选取直肠癌患者110例,根据IMA结扎部位分为A组(n=58)和B组(n=52),A组给予低位IMA结扎,B组给予高位IMA结扎;观察2组患者的手术时间、术中出血量、淋巴结清扫数目、肛门排气时间、排便功能、并发症及术后复发情况。结果:2组患者手术时间、术中出血量、淋巴结清扫数目比较,差异无统计学意义(P> 0. 05); A组患者肛门排气时间早于B组,差异有统计学意义(P <0. 05); A组患者术后6个月时排便功能评分低于B组,差异有统计学意义(P <0. 05); 2组患者吻合口瘘、尿潴留和肠梗阻发生率比较,差异无统计学意义(P> 0. 05); 2组患者术后复发率比较,差异无统计学意义(P> 0. 05)。结论:低位IMA结扎相较于高位IMA,在直肠癌手术中有较好的效果,具有并发症少等优点。
Objective: To investigate the effect of different ligation sites in inferior mesenteric artery( IMA) on therapeutic effect in rectal cancer surgery. Methods: One hundred and ten patients with rectal cancer were selected. According to IMA ligation site,patients were divided into group A( n =58) and group B( n = 52). Group A was given low IMA ligation,while group B were received high IMA ligation. The operation time,intraoperative blood loss,the number of lymph node dissection,anal exhaust time,defecation,complications and postoperative relapse were compared between the two groups. Results: There were no significant difference in operation time,the amount of bleeding and number of lymph node dissection between group A and group B( P > 0. 05). The anal exhaust started earlier in group A than in group B( P < 0. 05). At 6 months after operation,the defecation score was lower in group A than in group B. There was no significant difference in incidence of anastomotic leakage,urinary retention and intestinal obstruction between two groups( P > 0. 05). Moreover,relapse rate between group A and group B was similar. Conclusion: Compare with high IMA,low IMA ligation improves the effect of rectal cancer surgery and reduces complications.

关键词(KeyWords)： 肠系膜下动脉;结扎术;直肠肿瘤;临床效果;并发症
mesenteric artery,inferior;ligation;rectal neoplasms;clinical effect;complications

Abstract:

Keywords:

基金项目(Foundation): 2018年度安徽理工大学青年教师科学研究基金(QN2018126)

作者(Author): 季恩敏,张军,李昌权,李岗,史伟,于浩,李光云,田景中
JI Enmin,ZHANG Jun,LI Changquan,LI Gang,SHI Wei,YU Hao,LI Guangyun,TIAN Jingzhong

DOI: 10.19367/j.cnki.2096-8388.2020.09.020

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