手术治疗左半大肠癌并急性肠梗阻预后影响因素分析  

Influence factors of surgical treatment for left colorectal carcinoma with acute colorectal obstructive

作　　者：徐建康 方庆安 

机构地区：[1]南通市通州区余北医院普外科,江苏省南通226326

出　　处：《中国基层医药》2010年第21期2963-2965,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析手术治疗左半大肠癌并发急性肠梗阻的外科治疗效果及预后影响因素分析。方法左半结肠癌并发急性肠梗阻患者70例，行一期切除吻合术65例，二期肠吻合术5例。结果70例患者均治疗出院，术后并发症发生率为20．0％（14／70），病死率为1．0％（1／70）；根治性手术后1、3、5年累积生存率分别为100．O％、93．6％、66．7％，高于姑息性手术的69．2％、0．O％、0．0％（均P〈0．01）；单因素分析显示，肿瘤Dukes分期、肿瘤病理类型和化疗是影响左半大肠癌并梗阻术后生存率的重要因素（x2=16．546、20．649、5．953，均P〈0．01）；多因素分析显示，根治性手术是影响术后生存率的独立因素（Wald=5．877，P〈0．01）。结论一期根治手术治疗左半大肠癌并肠梗阻是可行的手术方式，可提高术后生存率。Objective To investigate the effect of surgical treatment in left coloreetal carcinoma with acute coloreetal obstructive. Methods Clinical data of 70 patients with acute left obstructive colorectal carcinoma treated by emergent operation were collected. 65 eases received one stage tumor resection and 5 cases received two stage tumor resection were retrospectively analyzed. Results The comphcation rate was 20.0% （14/70） ,mortality rate was 1.0% （1/70） ;radical surgery after 1,3,5-year cumulative survival rates were 100. 0% ,93.6% ,66. 7% wich were higher than the palliative surgery 69. 2%, 0. 0%, 0. 0% （ all P 〈 0. 01 ） ; With univariate analysis, radical resection, Dukes stage, tumor differentiation, and chemotherapy were found to be significant factors associated with the overall survival（ x2 = 16. 546,20. 649,5. 953, all P 〈 0. 01 ） ;with the overall survival. With multivariate analysis, radical re- section independently affected the overall survival（ Wald = 5. 877, P 〈 0. 01 ）. Conclusion One stage radical resec- tion was feasible for left obstructive colorectal carcinoma, and could improve survival rate after operation.

关 键 词：大肠肿瘤 肠梗阻 预后 影响因素 

分 类 号：R735[医药卫生—肿瘤]