食管癌手术吻合器使用型号与患者体表面积的关系

摘要

Objective It is to analyze the relationship between anastomat models and patients ’ body surface area in esoph-ageal carcinoma surgery , and determine the effective factors of anastomat models choice , provide statistical basis for operator to accurately determine anastomat models .Methods The relationship between anastomat models and patients ’ body surface area in esophageal carcinoma surgery were analyzed by SPSS 20.0 software for 200 patients with esophageal carcinoma surgery ( group A ) from January 2009 to December 2010 .The anastomat models were determined based on patients ’ body surface area before surgery for 230 surgical patients (group B) from January 2011 to December 2012.The anastomat models were deter-mined according to the anatomy of anastomosis operation area .If the statistical result accorded with the correlation conclusion so approved the type is appropriate , if inconformity , the operating room nurses gave assistance to operator to analyze affecting factors.Especially in the operator select anastomat models was greater than the statistical correlation of the assessment conclu -sion, the nurse should remind the operator , so that selected the appropriate type to ensure the operation completed successful-ly.Results There were 11 cases took the advice after statistical analysis of anastomat models in group B .anastomat models was smaller than the operator decided by subjective experience , accounted for 5%of the total .The other anastomat models de-cided by operator were consistented with the statistical conclusion .In the 11 cases, there were 4 cases during operation in sta-pling arrival of the nail seats was a bit difficult , accounting for 2%of the total number of cases .Conclusion There is signifi-cant correlation between anastomat models and patients ’ body surface .Anastomat models can decide by patient's body surface area .Choose the right type of anastomat after analyzing can increase the success rate of mechanical anastomosis , promote post-operative recovery , reduce postoperative complications;it is particularly useful for patients of older , longer course of disease , with poor nutritional status .%目的：分析吻合器使用型号与患者体表面积的关系，确定影响吻合器使用型号的有效因素，为术者准确判定吻合器使用型号提供统计学依据。方法对2009年1月-2010年12月实施手术的200例患者（ A组），使用SPSS 20．0软件将吻合器型号与体表面积进行统计学分析，找出相关性；对2011年1月-2012年12月实施手术的230患者（ B组），术前根据体表面积初步确定吻合器型号，手术中术者根据手术吻合区域的解剖情况先判断吻合器使用型号，如果符合统计结果的相关性结论，就可以认为该型号为适宜，如果不符合，则手术室护士协助术者共同分析影响因素，尤其在术者评估的吻合器型号大于统计的相关性结论时，更要提示术者，以便最终确定适宜的型号，保证手术顺利实施。结果在B组中，有11例手术采纳了经统计学处理后建议的吻合器型号，与术者凭主观经验决定的吻合器型号比较为较小，占病例总例数的5％；其余术者决定的吻合器型号与参考统计结论得出的结论一致。其中在采纳的11例手术中，置入吻合器抵钉座时，有4例在操作时置入抵钉座稍困难，占病例总数的2％。结论吻合器使用型号与患者体表面积之间具有相关性。在食管癌根治手术中决定吻合器使用型号时，可以参考患者的体表面积，进行分析后选择合适型号的吻合器，增加机械吻合成功率，促进患者术后顺利恢复，降低术后并发症的发生，对于高龄、病程较长、营养状况较差的患者尤其适用。