三排钉倾碟头吻合器在食管胃吻合术中应用研究.docVIP

三排钉倾碟头吻合器在食管胃吻合术中的应用研究 　　[摘要] 目的 回顾性研究分析三排钉倾碟头吻合器和两排钉吻合器行食管胃吻合术的临床应用效果，比较两者间差异并探讨其原因。方法 回顾性分析该院2013年1月―2015年12月收治的160例食管癌患者的临床资料。根据手术中随机使用的吻合器种类不同分为两组：A组为三排钉倾碟头吻合器组；B组为两排钉吻合器组，各80例。统计分析两组术后吻合口并发症的差异，并分析其原因。 结果 与两排钉吻合器组相比，三排钉倾碟头吻合器组术后吻合口瘘的发生率较低（1.25% vs 8.8%， χ2=5.02，P=0.026）；吻合口狭窄的发生率较低（6.3% vs 17.5%， χ2=4.49，P=0.036）；胃管引流出血性液体较少[（33.5±4.9）mL vs （76.3±39.5）mL， t=11.4， P0.001]。 结论 三排钉倾碟头吻合器与两排钉吻合器均可满足临床食管胃吻合术的需要，而前者术后吻合口并发症的发生率较低，值得临床推广应用。 　　[关键词] 三排钉倾碟头吻合器；食管胃吻合术；吻合口并发症。 　　[中图分类号] R608 [文献标识码] A [文章编号] 1674-0742（2017）12（b）-0101-03 　　[Abstract] Objective To retrospectively research and analyze the clinical application effect of three-row nail saucer-head stapler and two-row nail stapler in the esophagogastrostomy， compare the difference and discuss the reasons. Methods 160 cases of patients with esophageal cancer admitted and treated in our hospital from January 2013 to December 2015 were selected and randomly divided into two groups according to the operation method with 80 cases in each， the group A were the three-row nail saucer-head stapler group， while the group B were the two-row nail stapler group， and the differences in the complications at the stoma were counted， and the causes were analyzed. Results The incidence rate of anastomosis fistula in the three-row nail saucer-head stapler group was lower，（1.25% vs 8.8%， χ2=5.02， P=0.026）， and the incidence rate of stenosis of anastomotic stoma was lower（6.3% vs 17.5%， χ2=4.49， P=0.036）， and the gastric tube drainage hemorrhagic fluid was less [（33.5±4.9）mL vs （76.3±39.5）mL， t=11.4， P0.001]. Conclusion Both the three-row nail saucer-head stapler and two-row nail stapler can meet the clinical need of esophagogastrostomy， but the incidence rate of complications at the stoma is lower， and it is worth clinical promotion and application. 　　[Key words] Three-row nail saucer-head stapler； Esophagogastrostomy； Complications at the stoma 　　食管胃吻合口??、狭窄及出血是食管癌术后最常见的并发症。为了降低食管癌患者术后吻合口相关并发症的发生率，许多医生做了很多尝试与改进。该院从2013年1月―2