结、直肠癌并急性肠梗阻的外科处理并术后早期肠内营养支持  

Surgical treatment and early postoperative enteral nutrition of acute obstruction caused by colorectalcancer

作　　者：杨填 曾永明[1] 王怀明 郑周红[1] 李威[1] 

机构地区：[1]汕大医学院第一附属医院胃肠外科,汕头515041

出　　处：《中国综合临床》2013年第9期961-963,共3页Clinical Medicine of China

摘　　要：目的探讨结、直肠癌并急性肠梗阻的外科处理方法，验证“结肠前早期肠内营养支持”这一新方法在结直肠肿瘤并急性肠梗阻术后的可行性及效果。方法回顾分析我院自2007年9月至2012年9月收治的78例结、直肠癌并急性结肠梗阻病例，观察术后各项并发症（包括切口感染、腹腔脓肿、吻合口漏和肺炎等）发病率。结果62例患者行根治性手术并一期吻合，均痊愈出院，无死亡病例，术后出现并发症2例，全部患者无吻合口漏、引流口漏等并发症。结论结、直肠癌并急性肠梗阻术中灌洗并一期切除吻合是安全有效的，而术后早期应用肠内营养，能更好的解决围手术期营养不良，减少术后并发症，防止吻合口漏，提高手术成功率。Objective To investigate the method of surgical treatment of acute intestinal obstruction caused by colorectal cancer, and affirm the feasibility and validity of the new way of ＂ early precolonic postoperative enteral nutrition ＂ after operation of acute intestinal obstruction caused by colorectal cancer. Methods Retrospective analized the clinical data of 78 cases of acute intestinal obstruction caused by coloreetal caner from September 2007 to September 2012 and the incidence of complications （ incision infection, intra-abdominal abscess, anastomotic leakage, and pneumonia ） was observed. Results Sixty-two patients received radical resection and primary anastomosis. All of them were cured and no death occurred. Two patients had complication of postoperative infection and none suffered from anastomotic or drainage leakage. Conclusion Radical resection and primary anastomosis using Intra-operative colonic lavage are safe and effective methods for patients with colorectal cancer associated with acute intestinal obstruction, and ＂early precolonic postoperative enteral nutrition ＂ could better eliminate perioperative malnourished patients more, reduce operation complication, prevent anastomotic leakage, and increase the success rate of the operation.

关 键 词：肠内营养 结 直肠癌 急性肠梗阻 术中灌洗 一期切除吻合 

分 类 号：R735.3[医药卫生—肿瘤]