Zama N, Fazio V W, Jagelman D G, Lavery I C, Weakley F L, Church J M
Colorectal Surgery Department, Cleveland Clinic Foundation, Ohio 44195-5044.
Dis Colon Rectum. 1988 Dec;31(12):923-8. doi: 10.1007/BF02554887.
In a retrospective study, the records of 95 patients who underwent rectal resection for carcinoma were reviewed to assess the efficacy and complications of pelvic packing for hemorrhage. Heavier blood loss was noted with fixed tumors, where preoperative radiation had been given, or there had been previous pelvic surgery, compared with situations where these factors were absent. Three patients died from myocardial infarction, pulmonary embolus, and renal failure, respectively. No patients required further hemostatic measures after pack removal. Perineal wound infection or delayed perineal wound healing occurred in 22 percent and abdominal wound infection in 6 percent of the patients. There were no instances of anastomotic leak, abdominal abscess, or pelvic abscess requiring laparotomy for treatment in this series. Pelvic packing is a safe, simple, and effective procedure for patients with problematic pelvic bleeding after rectal resection.
在一项回顾性研究中，对95例行直肠癌直肠切除术患者的记录进行了审查，以评估盆腔填塞治疗出血的疗效和并发症。与不存在这些因素的情况相比，固定肿瘤、术前接受过放疗或既往有盆腔手术史的患者失血更多。3例患者分别死于心肌梗死、肺栓塞和肾衰竭。取出填塞物后，没有患者需要进一步的止血措施。22%的患者发生会阴部伤口感染或会阴部伤口愈合延迟，6%的患者发生腹部伤口感染。本系列中没有一例吻合口漏、腹腔脓肿或盆腔脓肿需要开腹治疗。对于直肠切除术后盆腔出血问题的患者，盆腔填塞是一种安全、简单且有效的方法。
