本文選題：直腸癌 + 腹腔鏡　； 參考：《青海大學(xué)》2017年碩士論文

【摘要】：目的:對(duì)比腹膜外隧道式造口和腹膜內(nèi)經(jīng)腹腔造口二者在一般手術(shù)并發(fā)癥、術(shù)后恢復(fù)和造口相關(guān)并發(fā)癥上是否存在差異,討論腹膜外造口的應(yīng)用價(jià)值。方法:記錄2015年12月至2016年12月就診于青海大學(xué)附屬醫(yī)院胃腸腫瘤外科及腹部腔鏡外科行腹腔鏡輔助腹會(huì)陰聯(lián)合直腸癌根治術(shù)的患者,選入腹膜外隧道式造口組35例為研究組,腹膜內(nèi)經(jīng)腹腔造口組30例為對(duì)照組。收集兩組的相關(guān)臨床資料進(jìn)行對(duì)比分析。結(jié)果:一般情況的差異在兩組間無統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)中情況:研究組和對(duì)照組在手術(shù)時(shí)間(220.09±27.04和212.47±20.45,P0.05)、造口時(shí)間(23.43±2.67min和22.17±3.02,P0.05)和手術(shù)出血量(183.71±85.89ml和172.33±76.77,P0.05)的差異均無統(tǒng)計(jì)學(xué)意義。術(shù)后恢復(fù):研究組和對(duì)照組在術(shù)后排氣時(shí)間(中位數(shù)2d和3d,P0.05)和術(shù)后住院天數(shù)(14.71±6.91d和17.33±4.40d,P0.05)上的差異無統(tǒng)計(jì)學(xué)意義,而在術(shù)后造口排便時(shí)間(中位數(shù)2d和3d,P0.05)和首次進(jìn)食時(shí)間(中位數(shù)2d和3d,P0.05)上差異有統(tǒng)計(jì)學(xué)意義。一般并發(fā)癥:研究組6例,對(duì)照組7例,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。造口并發(fā)癥:研究組和對(duì)照組分別為9例和15例,兩組差異在兩組間有統(tǒng)計(jì)學(xué)意義(P0.05)。造口水腫研究組和對(duì)照組分別出現(xiàn)7例和1例,造口水腫兩組患者的發(fā)生情況的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:腹膜外隧道式乙狀結(jié)腸造口相較腹膜內(nèi)經(jīng)腹腔造口有降低造口相關(guān)并發(fā)癥優(yōu)勢(shì)。術(shù)后消化功能恢復(fù)方面,腹膜外隧道式乙狀結(jié)腸造口術(shù)后排便時(shí)間和進(jìn)食時(shí)間早于腹膜內(nèi)經(jīng)腹腔造口。但是腹膜外隧道式乙狀結(jié)腸造口患者造口水腫發(fā)生率較腹膜內(nèi)乙狀結(jié)腸造口患者高。
[Abstract]:Objective: to compare the difference between extraperitoneal tunnel orifice and intraperitoneal orifice in general complications, postoperative recovery and postoperative complications, and to discuss the application value of extraperitoneal orifice. Methods: from December 2015 to December 2016, 35 patients with gastroenteric neoplasms and abdominal endoscopic surgery underwent laparoscopically assisted abdominal perineum combined rectal cancer resection, and 35 patients were selected as the study group. The 30 cases in the intraperitoneal orifice group were the control group. The clinical data of the two groups were collected and compared. Results: there was no significant difference in general conditions between the two groups (P 0.05), but there was no significant difference between the two groups in the operative time (220.09 鹵27.04 and 212.47 鹵20.45), the operative time (23.43 鹵2.67min) and the operative bleeding volume (183.71 鹵85.89ml and 172.33 鹵76.77 P0.05). Postoperative recovery: there was no significant difference between the study group and the control group in the postoperative exhaust time (median 2 d and 3 d P0.05) and the postoperative hospitalization days (14.71 鹵6.91 d and 17.33 鹵4.40 d P0.05). There was a significant difference in postoperative fecal time (median 2 d and 3 d P 0 05) and first feeding time (median 2 d and 3 d P 0 05). General complications: 6 cases in the study group and 7 cases in the control group, the difference was not statistically significant (P 0.05). Complications of anastomosis: 9 cases in the study group and 15 cases in the control group, the difference between the two groups was statistically significant (P 0.05). There were 7 cases and 1 case of ostomy edema in the study group and the control group respectively. There was significant difference in the occurrence of ostomy edema between the two groups (P 0.05). Conclusion: Extraperitoneal tunnel sigmoidostomy is superior to intraperitoneal orifice in reducing the complications associated with colostomy. The time of defecation and feeding after extraperitoneal tunnel sigmoidostomy was earlier than that of intraperitoneal stomy. However, the incidence of edema in patients with extraperitoneal tunnel sigmoidostomy was higher than that in patients with intraperitoneal sigmoidostomy.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.37

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郝偉秀;宋信英;;腹膜外造口及造口乳頭成形術(shù)的臨床應(yīng)用和意義[J];中國(guó)社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè));2011年18期

2 陳偉平;李德川;范永田;李其肯;朱玉萍;;腹腔鏡下乙狀結(jié)腸腹膜外造口的可行性研究(32例直腸癌應(yīng)用分析)[J];中國(guó)腫瘤;2007年06期

3 謝銘,王正光;改良腹膜外腸造口術(shù)45例療效分析[J];貴州醫(yī)藥;2005年04期

4 林榮華;;瓣式結(jié)腸腹膜外造口術(shù)的臨床研究[J];贛南醫(yī)學(xué)院學(xué)報(bào);2009年06期

5 肖俊興;李玲;羅逢啟;;螺旋形縫合結(jié)腸腹膜外造口術(shù)的臨床應(yīng)用[J];內(nèi)蒙古中醫(yī)藥;2012年21期

6 戴功建;金黑鷹;;腹腔鏡下直腸癌根治術(shù)乙狀結(jié)腸腹膜外造口的體會(huì)[J];臨床和實(shí)驗(yàn)醫(yī)學(xué)雜志;2013年17期

7 趙渭東;卜智斌;蔡長(zhǎng)友;王勇;宋少偉;張永輝;王新軍;;經(jīng)腹膜外乙狀結(jié)腸造口術(shù)62例分析[J];陜西醫(yī)學(xué)雜志;2009年10期

8 成軍;吳詠梅;李曉云;杜明國(guó);廖曉鋒;徐旭;;腹腔鏡Mile's術(shù)腹膜外造口體會(huì)[J];海南醫(yī)學(xué);2012年23期

9 龔航軍;韓剛;王以東;曹羽;;低位直腸癌腹腔鏡腹會(huì)陰切除術(shù)經(jīng)腹膜外隧道徑路造口的療效觀察[J];腹腔鏡外科雜志;2013年11期

10 邱磊;謝沛標(biāo);廖健南;廖一平;;直腸癌腹膜外乙狀結(jié)腸造口術(shù)20例臨床分析[J];中國(guó)醫(yī)師雜志;2006年12期

相關(guān)碩士學(xué)位論文 前4條

1 王奉冰;低位直腸癌腹腔鏡腹會(huì)陰聯(lián)合切除術(shù)腹膜外造口的應(yīng)用研究[D];蘇州大學(xué);2016年

2 熊亞立;手助腹腔鏡腹膜外造瘺的研究[D];重慶醫(yī)科大學(xué);2016年

3 鄧江岳;腹膜外造口在腹腔鏡腹會(huì)陰聯(lián)合直腸癌根治術(shù)中的應(yīng)用[D];青海大學(xué);2017年

4 陳震宏;經(jīng)腹膜內(nèi)和經(jīng)腹膜外腹壁結(jié)腸永久性造口比較分析[D];浙江大學(xué);2002年

，

本文編號(hào)：1801211