结肠癌合并肠梗阻手术治疗分析  

Efficacy of surgical treatment for colon cancer complicated with ileus

作　　者：沈晓览 王维健 徐钧 岳增辉 SHEN Xiao-lan;WANG Wei-jian;XU Jun;YUE Zeng-hui(Department of General Surgery,Shanghai Electric Power Hospital,Shanghai 200050,China)

机构地区：[1]上海电力医院普外科,上海200050

出　　处：《中国肿瘤临床与康复》2018年第12期1477-1480,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨结肠癌合并肠梗阻的手术治疗方法及治疗效果。方法选取2016年1月至2018年3月间上海电力医院收治的60例结肠癌合并肠梗阻患者,其中,采用I期结肠切除吻合术治疗的30例患者纳入观察组,采用分期结肠切除吻合手术治疗的30例患者纳入对照组。比较两组患者的淋巴结清扫数量、手术情况、术后恢复情况、术后吻合口瘘发生率、术后疼痛评分和血清炎症因子指标。结果两组患者的淋巴结清扫数量、术中出血量和手术用时比较,差异均无统计学意义(均P> 0. 05)。观察组的术后排气恢复时间、首次下床活动时间和住院时间均短于对照组,差异均有统计学意义(均P <0. 05)。两组患者术后吻合口瘘发生率比较,差异无统计学意义(P> 0. 05)。观察组患者术后8h、12h、24h和48h的切口疼痛评分均低于对照组患者,差异均有统计学意义(均P <0. 05)。观察组术后24h和48h的各项血清炎症因子指标均低于对照组,差异均有统计学意义(均P <0. 05)。结论结肠癌合并肠梗阻患者手术治疗时选择I期结肠切除吻合手术,可达到与分期手术相当的淋巴结清扫效果,还具有术后恢复快、术后疼痛感轻和术后炎症反应轻等优势。Objective To study the efficacy of surgical treatment for colon cancer complicated with ileus.Methods A total of 60 patients with colon cancer complicated with ileus undergoing surgery at Shanghai Electric Power Hospital from January 2016 to March 2018 were selected.Thirty patients undergoing Stage I colon resection and anastomosis were include in the observation group and 30 patinets undergoing the surgery in phases were included in the control group.The number of lymph node removed,surgery,postoperative recovery,the incidence of postoperative anastomotic fistula,postoperative pain score,and serum inflammatory factor indexes were compared two groups.Results There was no statistically significant difference in the number of lymph node removed,blood loss during the surgery,and the length of procedure between the observation group and the control group,(all P >0.05).Postoperative exhaust recovery time,time to out of bed activi- ty and hospitalization time were shorter in the observation group than in the control group (all P <0.05).There was no statistically significant difference in the incidence rate of postoperative anastomotic fistula between the groups (P >0.05).Postoperative incision pain score at 8h,12h,24h and 48h after the operation were all lower in the observation group than in the control group (all P<0.05).The serum inflammatory cytokines at 24h and 48h after the operation was lower in the observation group than in the control group (all P <0.05).Conclusion In patients with colon cancer complicated with intestinal obstruction,stage I colon resection and anastomosis can achieve good lymph node dissection comparable to surgery in phrases,and have advantages such as rapid postoperative recovery,mild postoperative pain,and light postoperative inflammatory response.

关 键 词：肛肠外科 结肠肿瘤 肠梗阻 Ⅰ期结肠切除吻合术 

分 类 号：R735.3[医药卫生—肿瘤]