| 标题： | 皮下持续负压引流预防结直肠癌伴肥胖患者剖腹根治术后切口脂肪液化及感染：单中心回顾性分析 |
| 摘要： |
目的：研究皮下持续负压引流（CNPD）对预防结直肠癌（CRC）伴肥胖患者行剖腹根治术后切口脂肪液化及感染的作用。方法：回顾性分析本院2005年1月至2015年6月行剖腹根治性切除术的CRC伴肥胖患者210例，统计行CNPD患者（引流组，91例）及直接切口缝合患者（无引流组，119例）切口脂肪液化及感染发生率、拆线时间、住院时间以及术后肠梗阻发生率。结果：引流组及非引流组患者切口脂肪液化率分别为3.3%、10.9%（χ2=4.236，P=0.039），感染率分别为2.2%、9.2%（χ2=4.408，P=0.036）。引流组术后拆线时间及住院时间均较非引流组短（t=2.537、2.032，P=0.027、0.045）。引流组患者术后发生肠梗阻比例更低（5.5% vs 15.1%，χ2=4.905，P=0.027）。亚组分析提示两组合并糖尿病患者脂肪液化率分别为4.0%、27.0%（χ2=5.421，P=0.020），切口感染率分别为4.0%、24.3%（χ2=4.556，P=0.033），差异有统计学意义。结论：皮下CNPD能够有效降低肥胖型CRC患者术后切口脂肪液化及感染率，缩短拆线时间、住院周期，且能够降低术后肠梗阻发生率，对于合并糖尿病的肥胖型CRC患者，CNPD预防切口脂肪液化及感染有明显优势。 |
| 英文摘要： | Objective：To study the subcutaneous continuous negative pressure drainage (CNPD) for the prevention of incision fat liquefaction and infection in colorectal cancer (CRC) patients with obesity undergoing open radical resection. Methods：A retrospective analysis of 210 obese patients with CRC receiving radical resection in our hospital from January 2005 to June 2015 were carried out to compare incision fat liquefaction and infection rate, clearing time, hospitalization interval and incidence of postoperative intestinal obstruction between patients of CNPD (drainage group, 91 cases) and non-CNPD (non-drainage group, 119 cases). Results：In drainage and non-drainage group, fat liquefaction rates were 3.3% vs 10.9% (χ2=4.236, P=0.039), the rate of incision infection were 2.2% vs 9.2% (χ2=4.408, P=0.036). The postoperative clearing time and hospitalization interval of drainage group were shorter than non-drainage group (t=2.537, 2.032, P=0.027, 0.045, respectively). The proportion of intestinal obstruction was lower in drainage group than that in non-drainage group (5.5 % vs 15.1%, χ2=4.905, P=0.027). The liquefaction rates of obese patients with diabetes mellitus were 4.0% vs 27.0% (χ2=5.421, P=0.020), and incision infection rate was 4.0% vs 24.3% (χ2=4.556, P=0.033) in two groups. Conclusions：CNPD can effectively reduce incision fat liquefaction and infection rate, shorten the clearing time and hospitalization period, and may reduce the incidence of postoperative intestinal obstruction. For patients with diabetes, CNPD has obvious advantages on preventing incision fat liquefaction and infection. |
| 作者： |
吕波1；王兵1；袁家天1；范俊1；邢莎莎2；张鑫1；冷书生1；李叔强1；强正宏1；曾云龙1；李俊1，2 |
| 作者单位： | 成都大学附属医院普外科1，中心实验室2 |
| 期刊： | 中华普通外科学文献(电子版) |
| 年.卷(期):页码 | 2016 .10（2）：103-107 |
| 中图分类号： | |
| 文章编号： | |
| 引用格式： | [1]吕波1；王兵1；袁家天1；范俊1；邢莎莎2；张鑫1；冷书生1；李叔强1；强正宏1；曾云龙1；李俊1，2.皮下持续负压引流预防结直肠癌伴肥胖患者剖腹根治术后切口脂肪液化及感染：单中心回顾性分析[J/CD].中华普通外科学文献（电子版）,2016,10(2):103-107. |
| 关键词： | 结直肠肿瘤 引流术 剖腹手术 脂肪液化 切口感染 |
| 英文关键词： | Colorectal neoplasms；Drainage；Open surgery；Fat liquefaction；Infection |
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