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目的探讨低位直肠癌保肛术吻合口瘘的预防措施与治疗方法。方法回顾性分析本院采用保肛术治疗的198例低位直肠癌患者的临床资料,其中有13例患者发生了吻合口瘘。结果年龄>60岁、合并高血压、低蛋白血症、糖尿病、合并肠梗阻、腹膜外吻合患者易发生吻合口瘘。6例患者吻合口瘘在观察过程中有显著腹膜炎现象出现,及时急诊剖腹探查,术后90d成功闭瘘,肠管连续性恢复正常。7例患者禁食并给予抗感染的常规治疗,同时行引流管抗生素溶液部分冲洗。13例吻合口瘘患者经过治疗,14～90d均痊愈出院。结论吻合口瘘可由多种原因造成,应给予针对性的治疗及预防措施,可有效的降低其发生率与二次手术率,减轻患者的痛苦。
Objective To investigate the prevention and treatment of anus anal fistula in low rectal cancer. Methods The clinical data of 198 patients with low rectal cancer who underwent anal sphincter preservation in our hospital were analyzed retrospectively. Thirteen of them had anastomotic fistula. Results Age> 60 years old, with hypertension, hypoproteinemia, diabetes mellitus, intestinal obstruction, extra-anastomosis patients prone to anastomotic fistula. 6 cases of patients with anastomotic leakage during the observation of significant peritonitis occurred, timely emergency exploratory laparotomy, 90 days after the successful closure of fistula, bowel continuity returned to normal. Seven patients were fasted and given anti-infective routine treatment while being partially irrigated with drainage tube antibiotic solution. 13 cases of anastomotic fistula after treatment, 14 ~ 90d were cured. Conclusion Anastomotic fistula can be caused by a variety of reasons, should be given targeted treatment and preventive measures, which can effectively reduce the incidence and the rate of secondary surgery to reduce the suffering of patients.