青岛大学医学院学报2017，Vol.53Issue(5)：555-558,4.DOI:10.13361/j.qdyxy.201705015
两种预防性回肠造口开放方式对低位直肠癌手术效果
EFFECT OF TWO OPENING METHODS FOR PROPHYLACTIC ILEOSTOMY ON SURGICAL OUTCOME OF LOW RECTAL CANCER
刘兆礼 1李大略 1赵资文 1王冬 1王东升1
作者信息
- 1. 青岛大学附属医院胃肠外科,山东青岛266003
- 折叠
摘要
Abstract
Objective To investigate the effect of stage Ⅰ opening versus stage Ⅱ opening of prophylactic ileostomy on postoperative recovery and immune function in patients with low rectal cancer.Methods A total of 89 patients with low rectal cancer who underwent laparoscopic low anterior resection of rectal cancer and prophylactic terminal ileostomy in Department of Gastrointestinal Surgery were enrolled and randomly divided into stage Ⅰ opening group with 45 patients and stage Ⅱ opening group with 44 patients.The two groups were compared in terms of postoperative recovery,complications,quality of life,and immune function.Results Compared with the stage Ⅱ opening group,the stage Ⅰ opening group had a significantly longer time of operation (t =2.848,P ＜0.05),as well as significantly shorter time to postoperative pyrexia and length of postoperative hospital stay and significantly lower hospital costs (t =2.163-8.280,P ＜0.05).There were no significant differences in the incidence rates of ileostomy-related complications and systemic complications between the two groups (P＞0.05).The stage Ⅰ opening group had a significantly higher quality of life score at discharge than the stage Ⅱ opening group (t=5.402,P＜0.05).On 3 d after surgery,the stage Ⅰ opening group had significantly higher levels of IgA and IgG than the stage Ⅱ opening group (t =4.789-5.553,P＜0.05);on 7 d after surgery,the stage Ⅰ opening group had significantly higher percentage of CD4+,CD4+/CD8+ ratio,and levels of IgA,IgM,and IgG than the stage Ⅱ opening group (t =5.774-16.373,P＜0.05).The influence of time factor on immune function did not change with the opening method for ileostomy (P＞0.05).Conclusion Stage Ⅰ opening of prophylactic ileostomy is safe and effective and can improve patients' immune function and promote their recovery after surgery.关键词
直肠肿瘤/回肠造口术/免疫系统/生活质量Key words
rectal neoplasms/ileostomy/immune system/quality of life分类
医药卫生引用本文复制引用
刘兆礼,李大略,赵资文,王冬,王东升..两种预防性回肠造口开放方式对低位直肠癌手术效果[J].青岛大学医学院学报,2017,53(5):555-558,4.
