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目的:评价无支撑回肠造口在低位直肠切除术中应用的安全性和有效性。方法:回顾性分析2007年10月～2010年12月南京中医药大学第三附属医院全国肛肠医疗中心对67例采用无支撑的回肠造口术的临床资料。结果:本组患者平均年龄54岁,14例(20.8%)出现术后并发症。7例(10.4%)患者造口出现水肿,未经特殊处理,约2周后恢复正常;4例(5.9%)患者出现造口周围皮肤炎,经对症治疗后好转;2例(3.0%)患者出现造口旁疝,1例(1.5%)患者于术后4个月时出现造口脱垂,未进行特殊处理;未发生造口回缩。结论:本组较大样本、较长的随访时间证实无支撑回肠造口具有制作简单、安全性好、粪便转流彻底、并发症少、易于护理、易于还纳等优点,具有良好的安全有效性,可较好地应用于低位结肠肛管吻合术中的预防性回肠造口,而且造口还纳后的并发症低于文献报道。
Objective: To evaluate the safety and efficacy of unsupported ileostomy in lower rectal resection. Methods: The clinical data of 67 cases of unsupported ileostomy were retrospectively analyzed from October 2007 to December 2010 at National Anorectal Medical Center of the Third Affiliated Hospital of Nanjing University of Traditional Chinese Medicine. Results: The average age of patients in this group was 54 years. Postoperative complications occurred in 14 patients (20.8%). In 7 patients (10.4%), the stoma was edematous and returned to normal after about 2 weeks without any special treatment. Dermatitis around the stoma was found in 4 patients (5.9%), which improved after symptomatic treatment. Two patients (3.0% Parastomal hernias were observed in 1 patient (1.5%). Stoma prolapse occurred at 4 months after surgery and no special treatment was performed; no stoma retraction occurred. Conclusion: The larger sample of this group, with longer follow-up time, confirmed that the unsupported ileostomy has the advantages of simple manufacture, good safety, thorough feces commutation, fewer complications, easy care, easy to pay and so on, which has good safety and efficacy Which can be better applied to the preventive ileostomy in the lower colon anastomosis. The complications after the stoma were also lower than those reported in the literature.