【摘要】 目的研究M iles术后骶前引流和会阴缝合切口的处理方法。探索M iles术后会阴切口感染的防治方法。方法109例直肠癌M iles手术患者,随机分为A组57例,行经会阴切口旁骶前引流;B组52例,联合行经右髂部合并经会阴切口旁骶前引流。如术后发生会阴切口感染,A组拔除经会阴切口旁引流管行开放换药;B组除拔除经会阴切口旁引流管行开放换药外,同时保留经右髂部引流管进行主动引流。结果A组会阴切口感染率为19.3%(11/57),与B组的17.3%(9/52)比较,无统计学差异(P>0.05)。会阴切口感染后,A组换药时间为35~50 d,平均(42.8±5.4)d;B组换药时间为21~35 d,平均为(27.8±4.9)d,A组明显长于B组,P<0.05。结论M iles术后联合经右髂部合并经会阴切口旁骶前引流有利于盆腔创面的愈合;一旦会阴切口发生感染,拔除经会阴切口旁引流管,保持经右髂部引流管进行主动引流,会阴切口经换药可较快愈合。更多还原

【Abstract】 Objective To explore the methods and efficacies of presacral drainage in patients with rectal cancer after Miles operation.Methods 109 patients with rectal cancer underwent Miles operations were divided randomly into two groups.In Group A,there were 57 patients placed a presacral drainage tube beside the transperineal incision.In Group B,there were 52 patients placed two combined presacral drainage tubes,of which one beside the transperineal incision,and the other was placed through the right iliac region.If the sutured perineal incision developed infection,the presacral drainage tube beside the transperineal incision would be pulled out,and the perineal wound would be openly dressed every day.Besides,in Group B,the right iliac presacral drainage tube would be reserved for active drainage.Results The infection rate of the sutured perineal wound was 19.3%(11/57) of Group A,and 17.3%(9/52) of Group B.There was no significant difference(P>0.05).In the perineal wound infected cases,the dressing change time was(42.8±5.4)days in Group A,which was significantly longer than Group B,(27.8±4.9)days(P<0.05).Conclusions Two combined presacral drainage tubes,of which one placed beside the transperineal incision,and the other through the right iliac region,are benefit to the healing of the pelvic cavity.And the infected perineum incision can get a quick recovery course by the active drainage through the right iliac presacral drainage tube.更多还原