Hartmann手术治疗大肠癌合并急性肠梗阻的临床分析  

Clinical Analysis of Hartmann’s Procedure in Treatment of Colorectal Carcinoma Complicated with Acute Obstruction

作　　者：王自明[1] 林伶[2] 

机构地区：[1]湖南师范大学附属湘东医院,湖南醴陵412200 [2]中南大学湘雅医院卫生部肝胆肠外科研究中心,湖南长沙410008

出　　处：《中国医药指南》2013年第22期29-29,28,共2页Guide of China Medicine

摘　　要：目的探讨Hartmann手术治疗大肠癌合并急性肠梗阻的临床效果。方法对2010年6月至2012年6月51例行Hartmann手术治疗的大肠癌合并急性肠梗阻患者的临床资料进行回顾性分析,评估手术适应症、效果及局限性。结果 51例患者均顺利完成手术。行Ⅰ期肿块切除,Ⅱ期肠吻合35例(68.63%);行姑息手术16例(31.37%)。手术时间平均210 min,术中失血量平均190 mL,平均住院时间17 d。术后出现并发症7例(13.73%),其中切口裂开1例(1.96%),切口感染2例(3.92%),腹腔感染2例(3.92%),造口狭窄2例(3.92%)。术后随访平均5-20个月,局部复发5例(9.8%),远处转移19例(37.25%)。结论 Hartmann手术对大肠癌合并急性肠梗阻患者是及时有效的手术治疗措施,可有效改善患者生存质量,延长患者的生存时间,也为二期手术创造了有利条件,但应结合患者具体病情和术式特点选择应用。Objective To analyze and discuss the clinical effect of Hartmann＇s procedure in treatment of colorectal carcinoma complicated with acute obstruction. Methods Retrospectively analyzed the clinical datum of 51 cases colorectal carcinoma complicated with acute obstruction underwent Hartmann operation from 2010 June to 2012 June, assess the indications, results and limitations. Results 51 cases were performed Hartmann＇s operation successfully. 35 cases （68.63 %） underwent phase I resection, phase II anastomosis; 16 cases （31.37 %） underwent palliative operation. The average operation time was 210 vain, the average volume of intra-operative blood loss was 190 mL, the average hospitalization time was 17 d. Postoperative complications occurred in 7 cases （13.73 %）, 1 ease （1.96 %） disruption of incision, 2 cases （3.92 %） surgical site infection, 2 cases （3.92 %） abdominal infection. The postoperative follow-up time from 5 to 20 months, 5 cases （9.8 %） have local recurrence, 19 cases （37.25 %） have metastases. Conclusions Hartmann＇s procedure can effectively improve the patients life quality, prolong the survival time, and provide opportunity for the phase II anastomosis, but the patients＇ conditions the and procedure＇s characteristics should be fully considered preoperatively.

关 键 词：Hartmann术式 结、直肠癌 肠梗阻 

分 类 号：R574.2[医药卫生—消化系统]