Ryan P, Schweitzer S A, Woods R J
Colorectal Unit, St. Vincent's Hospital, Melbourne, Australia.
Eur J Surg. 1992 Jan;158(1):45-9.
To find out whether patients did better after operations that entailed a large bowel anastomosis if they were given combined epidural and general anaesthesia with spontaneous ventilation rather than standard general anaesthesia with muscle relaxation and ventilation.
Prospective randomised trial.
Specialist unit, teaching hospital.
80 patients undergoing large bowel anastomoses.
Incidence of chest infection, wound infection, anastomotic breakdown, urinary tract infection, deep vein thrombosis, pulmonary embolism, median hospital stay and death.
There were no differences between the groups, but the results were better during the trial period (1985-89) than during the period 1978-83.
Factors that influence anastomotic healing are complex and improved surgical techniques, postoperative monitoring and patient care may account for the improvement in results compared with the earlier period.
探讨接受大肠吻合术的患者，采用硬膜外麻醉联合全身麻醉并自主通气，与采用标准全身麻醉并肌肉松弛及机械通气相比，术后恢复情况是否更好。
前瞻性随机试验。
教学医院的专科病房。
80例行大肠吻合术的患者。
肺部感染、伤口感染、吻合口漏、尿路感染、深静脉血栓形成、肺栓塞、中位住院时间及死亡发生率。
两组之间无差异，但试验期间（1985 - 1989年）的结果优于1978 - 1983年期间。
影响吻合口愈合的因素复杂，与早期相比，手术技术的改进、术后监测及患者护理的改善可能是结果改善的原因。
