【摘要】 目的　探讨腹膜外结肠造口术在肛管直肠癌治疗中的临床效果。方法　对本院自 1998年 8月至2 0 0 0年 4月收治的肛管直肠癌施行腹膜外结肠造口术 5 3例病人与施行传统Miles术 76例腹膜内结肠造口术病人的效果比较 ,观察造口并发症和排便功能改善情况。结果　 5 3例腹膜外结肠造口术病人经 1～ 19个月的随访 ,除有 2例出现造口周围皮肤炎外 ,尚未发现其他并发症 ,并发症发生率为 3 .8% ,37例病人获排便感。对照组造口狭窄率 5 .2 % (4例 ) ,术后肠梗阻 2 .6 % (2例 ) ,造口周围皮肤炎 6 .6 % (5例 ) ,腹腔内疝 2 .6 % (2例 ) ,造口旁疝 1.3 %(1例 ) ;总术后并发症率为 18.4% ,无 1例病人有排便感 ,两组差异有显著性 (χ2 =6 .16 P <0 .0 5 )。结论　腹膜外造口具有并发症少 ,排便功能好 ,易于术后管理等优点更多还原

【Abstract】 Objectives To explore the clinical effects for peritoneal colostomy in the treatment of anorectum carcinoma. Methods There were 53 patients with rectal carcinoma received extraperitoneal colostomy. The control group was made up of another 76 rectal carcinoma patients who received the traditional Miles’ operation, hospitalized from Aug. 1998 to Apr. 2000 in our hospital. Postoperative complications and functions of defection in the two groups were compared.Results The 53 patients with extraperitoneal colostomy were followed-up for 1-19 months. Two of them suffered from skin inflammation around the colostomy, other complications weren’t found. The morbidity of complications was about 3.8% and 37 patients got continenec colostomy. The morbidity of colostomy stenosis of the control group was about 5.2% (4 cases), obstruction of the intestine 2.6% (2 cases), skin inflammation around the colostomy 6.6% (5 cases), intra-abdomen hernia 2.6% (2 cases), side-colostomy hernia 1.3% (1 case) and the total postoperative morbidity of the control group was much higher (18.4%) and no one of them got continence colostomy.There was a significant difference between the two groups (X2 = 6.16 P < 0.05).Conclusion The extraperitioneal colostomy had less complications,better fuctions of defecation and easier management after operation.更多还原