腹腔镜与开腹手术治疗结直肠癌患者临床疗效和术后肠梗阻发生率的比较  

Comparison of clinical efficacy and incidence of postoperative intestinal obstruction of laparoscopy and laparotomy in the treatment of colorectal cancer

作　　者：陈先达[1] 黄锦荣[1] 郑赟[1] 

机构地区：[1]福建医科大学附属宁德市医院普外科,宁德352100

出　　处：《中国肿瘤临床与康复》2015年第11期1367-1369,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨腹腔镜与开腹手术治疗结直肠癌患者临床疗效及术后肠梗阻的发生率。方法选取2011年2月至2014年5月间收治的94例结直肠癌患者,按照随机数表法分为观察组和对照组,每组47例。观察组患者采用腹腔镜下手术治疗,对照组患者采用传统的开腹手术治疗,观察两组患者手术时间、术中出血量、肛门排气时间及住院时间,并比较术后并发症及肠梗阻的发生情况。结果观察组患者手术时间明显长于对照组(P<0.05),但观察组患者术中出血量、肛门排气时间及住院时间明显低于对照组,差异均有统计学意义(P<0.05)。两组患者术后输尿管损伤、下肢静脉血栓、感染、切口脂肪液化及吻合口瘘的发生率差异无统计学意义(P>0.05)。观察组患者的肠梗阻发生率为8.5%,对照组为25.5%,组间差异有统计学意义(P<0.05)。结论与开腹手术相比,腹腔镜下结直肠癌手术治疗结直肠癌的效果更佳,可降低术中出血和术后肠梗阻的发生率,对患者的创伤小,有利于患者恢复。Objective To compare the clinical efficacy and incidence of postoperative intestinal obstruction of laparoscopy and laparotomy in the treatment of colorectal cancer. Methods From February2011 to May 2014,94 colorectal cancer patients were divided into the observation group and the control group,47 cases in each group. The patients in the observation group accepted laparoscopic surgery and those in the control group was accepted laparotomy. The operation time,intraoperative blood loss,anal exhaust time and hospital stay were compared between the two groups. The postoperative complications were also compared. Results The operation time of the observation group was obviously longer than that of the control group（ t = 5. 765,P 0. 05）,but the intraoperative blood loss,anal exhaust time and hospitalization time of the observation group were significantly lower than those of the control group（ t = 6. 806,6. 611,7. 700,P 0. 05）; there was no statistically significant difference between the two groups in postoperative ureteral injury,lower limb vein thrombosis,infection,the fat liquefaction of incision and anastomotic fistula in postoperative complications（ P 0. 05）. The total incidence of intestinal obstruction in the control group was 25. 5%,the observation group 8. 5%（ 2= 4. 821,P 0. 05）. Conclusion Compared with open surgery,laparoscopic treatment of colorectal cancer is good and can reduce intraoperative bleeding and the occurrence of postoperative ileus.

关 键 词：结直肠肿瘤 腹腔镜 开腹手术 肠梗阻 

分 类 号：R735.34[医药卫生—肿瘤]