择期结肠直肠手术中机械肠道准备与非肠道准备的比较研究

Molla Sharfuddin Ahmed, Md Ibrahim Siddique
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引用次数: 0

摘要

背景:现代手术技术和术前护理的改善降低了结直肠手术的发病率和死亡率,但机械肠道准备的作用最近受到争议。没有机械肠道准备的原发性结肠吻合仍然被认为是不安全的。目的:本研究的目的之一是评估术前机械肠准备在预防择期结肠和直肠手术吻合口和伤口裂开中的作用。方法:将50例患者随机分为A组和B组,A组为预备组,B组为非预备组。预备组采用口服聚乙二醇进行机械肠道准备,非预备组不进行肠道准备。所有患者均由合格的外科医生进行手术,随访结果并对收集的数据进行分析。结果:A组80%的患者出现恶心、呕吐、血块、运动松散等肠准备不良反应,需采取预防措施。两组患者术前均给予抗生素治疗,其中A组24例,B组23例输血。A组15例(60%)出现术后感染并发症。A组以手术部位感染为主(10.40%),其次为吻合口漏、腹内脓肿和腹膜炎,B组有10例(40%)出现手术并发症。结论:择期结肠直肠手术前机械准备对预防并发症效果不佳,无需机械准备即可安全进行结肠直肠手术。外科杂志(2017)Vol. 21 (2): 105-109
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A Comparative Study between Patients with Mechanical Bowel Preparation and Patients with No Bowel Preparation in Elective Colo-rectal Surgery
Background: Modern surgical techniques and improved preoperative care has reduced both morbidity and mortality of colorectal surgery but the role of mechanical bowel preparation is recently disputed. Primary colonic anastomosis without mechanical bowel preparation is still considered unsafe. Objective: One of the objectives of this study was to evaluate pre-operative mechanical bowel preparation in preventing anastomotic and wound dehiscence in elective colon and rectal surgery. Methods: Fifty patients who were included in this study were randomly divided into two groups (group A & Group B). Group A was the preparatory group and Group B was the non-preparatory group. In preparatory group oral poly ethylene glycol was used for mechanical bowel preparation and in non-preparatory group no bowel preparation done. All patients were operated on by qualified surgeons and followed up for outcome and collected data were analyzed. Results: 80% of the Patients in Group A had adverse effects of bowel preparation like nausea, vomiting, blotting, loose motion and precaution had to be taken for them. All the patients of both groups were given per-operative antibiotics whereas 24 patients of Group A and 23 patients of Group B were given transfusion. 15(60%) patients of Group A had developed post-operative surgical infectious complications. The majority number of patients of Group A had been suffered from surgical site infection (10, 40%) followed by Anastomotic Leak, Intra-abdominal abscess and Peritonitis whereas in Group B 10(40%) patients developed surgical complications. Conclusion: Mechanical bowel preparation before elective colon and rectal surgery is not so effective in preventing complications and without any mechanical preparation of the bowel colorectal surgery can be done safely. Journal of Surgical Sciences (2017) Vol. 21 (2): 105-109
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