Search

Clinical Application of Continuous Double Perfusion Cannula Accompanied with Negative Pressure Drainage in Abdominal Surgery

目的观察持续冲洗负压引流技术在腹部外科应用的临床效果。方法回顾性分析2006年1月至2011年3月期间我院将自制双套管实施持续冲洗负压引流技术应用于172例腹部外科患者的临床资料。结果全部患者的消化道瘘均治愈，瘘道愈合的平均时间为36 d。治疗过程中，1例患者出现上消化道出血，另1例出现腹腔出血，无腹腔感染、皮肤破溃感染、脓毒症等并发症。结论采用持续冲洗负压引流的双套管制作简单，经济有效，在腹部外科中对术后肠瘘、出血、胆汁漏及感染的防治具有重要临床意义。

Application of Self-Made Double Cannula Combined with Continuous Negative Pressure Suction for Rectal Cancer During Operation

目的探讨自制双套管持续负压吸引对低位直肠癌经腹前切除术后吻合口漏的防治效果。 方法2006年1月至2012年12月期间笔者所在医院施行了106例低位直肠癌经腹前切除术，均采用自制双套管持续负压吸引，回顾性分析其预防和治疗吻合口漏的效果。 结果本组106例患者术后发生吻合口漏6例（5.66%），给予双套管持续滴注冲洗结合持续低负压吸引，同时给予全身抗感染、禁食、肠外营养或后期肠内营养处理。12～16 d（平均14 d）后患者的大便成型、冲洗液清亮，遂拔除引流管。其中1例为直肠阴道瘘，经保守治疗失败后行横结肠双腔造瘘术，于术后6周恢复，3个月后行造瘘口关闭术。 结论低位直肠癌保肛手术应用自制双套管持续负压吸引技术后，吻合口漏的发生率较低；其还能有效控制盆腔感染，从而促进漏口愈合。

Application of The Double Cavity Casing Negative Pressure Drainage by Inside and Outside of The Intestine in The Primary Resection and Anastomosis of Left Colon Cancer Combined with Acute Obstruction

ObjectiveTo investigate the feasibility and safety of the double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis of left colon cancer combined with acute obstruction. MethodsEighty-one cases of left colon cancer combined with acute obstruction who underwent surgeries in our hospital from January 2009 to December 2012 were collected prospectively, and were divided into one-stage surgery group (n=41) and control group (n=40). Cases of one-stage surgery group received double cavity casing negative pressure drainage by inside and outside of the intestine in the primary resection and anastomosis, and cases of control group underwent two-stage surgeries. Comparison of operation time, blood loss, time of anal exhaust after operation, hospital stay, hospital expense, and incidence of complication between the 2 groups was performed. ResultsThere were no significant difference in the operation time[(166±19) minutes vs. (173±23) minutes], blood loss[(253±42) mL vs. (273±50) mL], and time of anal exhaust after operation[(3.24±0.73) days vs. (3.50±0.95) days]beeween one-stage surgery group and control group, but hospital stay[(15.1±2.3) days vs. (23.1±4.1) days]and hospital expense[(3.70±0.68) ×105 yuan vs. (5.77±0.95) ×105 yuan]of one-stage surgery group were lower than those of control group (P<0.05). In addition, there were no significant difference in the incidences of wound infection[7.3% (3/41) vs. 10.0% (4/40)], intraabdominal infection[4.9% (2/41) vs. 10.0% (4/10)], pulmonary infection[12.2% (5/41) vs. 15.0% (6/40)], and anastomotic leakage[2.4% (1/41) vs. 5.0% (2/40)]beeween one-stage surgery group and control group (P>0.05). All of the cases were followed up for 1-36 months, and the median time were 22 months. There were no significant difference in the mortality[0 (0/41) vs. 2.5% (1/40)], recurrence rate[2.4% (1/41) vs. 5.0% (2/40)], and metastasis rate[7.3% (3/41) vs. 10.0% (4/40)]beeween one-stage surgery group and control group too (P>0.05). ConclusionIn the case of negative pressure drainage of double cavity casing, underwent decompression of the small bowel, and irrigation of colon, the primary resection and anastomosis of left colon cancer combined with acute obstruction was safe and feasible.

目的 探讨自制双套管持续冲洗负压引流治疗胰腺术后胰瘘的效果。 方法 回顾性分析2008 年 8 月至2014 年3 月期间于笔者所在医院接受自制双套管持续冲洗负压引流治疗的12 例胰瘘患者的临床资料，总 结效果。 结果 12 例患者均接受双套管持续冲洗负压引流治疗，治疗期间引流管若有堵塞，可拔出体外清理。所 有患者均于拔管后治愈。更换双套管早期（1 ～ 3 d）患者发热等感染症状明显缓解，引流10 ～ 22 d 后引流量逐渐 减少。出院后所有患者均获访6 个月，患者恢复良好，胰瘘部位包裹吸收，无并发症发生。 结论 自制双套管持续 冲洗负压引流治疗胰腺术后胰瘘的效果满意，安全可行。

EnCor 真空旋切加双套管负压引流治疗乳腺脓肿

目的 探讨高频超声引导下 EnCor 真空旋切加双套管负压引流治疗乳腺脓肿的可行性及其临床应用价值。 方法 回顾性分析 2012 年 10 月至 2015 年 10 月期间于南京医科大学附属淮安第一医院治疗的 41 例乳腺脓肿患者的临床病理资料，其中有 20 例行 EnCor 真空旋切加双套管负压引流术（EnCor 组），21 例行常规切开引流术（对照组），比较 2 组患者疗效的差异。 结果 2 组患者在年龄、脓肿直径、脓肿位置等一般资料比较差异无统计学意义（P>0.05）。2 组患者手术治疗顺利，但 EnCor 组中有 2 例在旋切过程中发生出血，局部加压 1 h 后成功完成真空旋切术。2 组的手术时间比较差异无统计学意义（P>0.05）。EnCor 组的切口瘢痕大小、治愈时间、住院时间、换药次数及疼痛评分均明显优于对照组（P<0.05）。所有患者术后均治愈出院，无一例再手术，无术后出血、皮肤损伤、乳糜漏等并发症发生。41 例患者术后随访 3～20 个月，平均 12 个月，无一例失访。查体结合高频超声检查无脓腔残留及复发征象。对照组切口疤痕较明显，有1 例发生乳房变形；而 EnCor 组切口瘢痕微小，患者对术后乳房外形及治疗效果均满意。 结论 本研究的初步结果提示，EnCor 真空旋切辅以双套管负压引流治疗乳腺脓肿安全、可靠、痛苦小且微创。