腔内双套管吸引在十二指肠破裂修补术中的应用

Application of intracavity double pipe suction in the repair of duodenal rupture

  • 摘要: 目的:探讨十二指肠腔内双套管负压吸引在十二指肠破裂修补术中的应用价值。
    方法:回顾性分析2003年1月至2014年1月南京军区福州总医院收治的56例行十二指肠破裂修补术患者的临床资料,十二指肠减压方法为经胃十二指肠单纯引流者31例(单纯引流组),经胃十二指肠腔内双套管负压吸引者25例(双套管吸引组)。观察两组患者术后十二指肠引流液量、并发症发生率、住院时间及住院费用。计量资料组间比较采用重复测量的方差分析和t检验,计数资料比较采用χ2检验或Fisher确切概率法。
    结果:双套管吸引组患者术后第1~7天十二指肠引流液量分别为(220±54)mL、(284±65)mL、(368±35)mL、(413±41)mL、(454±62)mL、(714±96)mL、(852±121)mL,高于单纯引流组患者的(102±30)mL、(124±29)mL、(186±26)mL、(110±21)mL、(167±31)mL、(193±35)mL、(182±44)mL,两组比较,差异有统计学意义(F=65.214,P<0.05)。进一步对术后第1~7天各时间点两组患者引流量进行比较,差异均有统计学意义(t=9.532,11.624,13.421,15.257,14.147,18.311,20.135,P<0.05)。单纯引流组患者术后十二指肠瘘、腹腔感染和切口感染发生率分别为29.0%(9/31)、41.9%(13/31)和51.6%(16/31),均高于双套管吸引组患者的4.0%(1/25)、12.0%(3/25)和16.0%(4/25),两组比较,差异均有统计学意义(χ2=4.460,6.077,7.645,P<0.05)。单纯引流组和双套管吸引组患者术后胰瘘及肺部感染发生率分别为16.1%(5/31)和29.0%(9/31)、8.0%(2/25)和12.0%(3/25),两组比较,差异均无统计学意义(χ2=0.836,2.385,P>0.05)。单纯引流组患者术后住院时间和住院费用分别为(30±14)d和(12±6)万元,双套管吸引组分别为(21±7)d和(7±5)万元,两组比较,差异均有统计学意义(t=3.161,2.913,P<0.05)。
    结论:十二指肠腔内双套管负压吸引操作简单,可降低患者十二指肠破裂修补术后并发症发生率,缩短住院时间和减少住院费用,值得临床推广应用。

     

    Abstract: Objective:To investigate the effects of intracavity double pipe suction in the duodenal rupture repair.
    Methods:The clinical data of 56 patients with duodenal rupture repair who were admitted to Fuzhou General Hospital from January 2003 to January 2014 were retrospectively analyzed. Thirty one patients and 25 patients received the simple drainage (simple drainage group) and intracavity double pipe suction (intracavity double pipe suction group) for duodenal rupture repair. Quantitative data were presented by 〖AKx-D〗±s, repeated measures analysis of variance and the t test were used to evaluate quantitative data, respectively. Count data were analyzed using Chi square test or Fisher′s exact test.
    Results:Volume of drainage of patients in the intracavity double pipe suction group at day 1, 2, 3, 4, 5, 6, 7 were (220±54)mL, (284±65)mL, (368±35)mL, (413±41)mL, (454±62)mL, (714±96)mL and (852±121)mL, compared with (102±30)mL, (124±29)mL, (186±26)mL, (110±21)mL, (167±31)mL, (193±35)mL and (182±44)mL in the simple drainage group, with a significant difference between the 2 groups (F=65.214, P<0.05). The volumes of drainage of the 2 patterns were compared at postoperative day 1 to 7, with a significant difference (t=9.532, 11.624, 13.421, 15.257, 14.147, 18.311, 20.135, P<0.05). The incidence of duodenal fistula, intraperitoneal infection and wound infection in the simple drainage group were 29.0%(9/31), 41.9%(13/31) and 51.6%(16/31), compared with 4.0%(1/25), 12.0%(3/25) and 16.0%(4/25) in the intracavity double pipe suction group, showing a significant difference between the 2 groups (χ2=4.460, 6.077, 7.645, P<0.05). The incidence of pancreatic fistula and pulmonary infection in the sample drainage group and intracavity double pipe suction group were 16.1%(5/31) and 29.0%(9/31), 8.0%(2/25) and 12.0%(3/25), with no significant difference between the 2 groups (χ2=0.836, 2.385, P>0.05).
    The duration of hospital stay and hospital expenses in the simple drainage group and the intracavity double pipe suction group were (30±14)days and(12±6)×104 yuan,(21±7)days and (7±5)×104 yuan, respectively, with significant difference between the 2 groups (t=3.161, 2.913, P<0.05).
    Conclusion:The intracavity double pipe suction for duodenal rupture repair is simple and effective for significantly improving the prognosis of patients and reducing the duration of hospital stay and hospital expenses.

     

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