术中结肠灌洗在老年左半结直肠癌合并梗阻患者的应用  

Application of intraoperative colonic irrigation in elderly patients of left colorectal cancer with colonic obstruction

作　　者：何平[1] 陈进[1] 谢智惠[1] 邱明远[1] 

机构地区：[1]江南大学附属医院(无锡市第四人民医院)肿瘤外科,江苏省214062

出　　处：《江苏医药》2016年第1期63-65,共3页Jiangsu Medical Journal

摘　　要：目的探讨术中结肠灌洗在老年左半结直肠癌合并梗阻患者的应用效果。方法 70岁以上左半结肠癌、直肠癌(上段)合并肠梗阻的患者56例分为两组:A组24例术中行结肠灌洗,实施左半结肠或直肠Ⅰ期切除吻合手术;B组32例采用左半结肠或直肠切除+结肠造瘘术。观察A组术后吻合口瘘的发生,比较两组手术时间、术后感染、术后住院时间和围手术期死亡发生情况。结果A组出现吻合口瘘1例(4.2%)。A组手术时间长于B组[(175±14.5)min vs.(143±12.7)min](P<0.05)。两组术后感染、术后住院时间和围手术期死亡率差异无统计学意义(P>0.05)。结论经严格选择手术适应证,老年左半结直肠癌合并梗阻患者术中结肠灌洗后行Ⅰ期切除吻合是安全可行的。Objective To invest!gate the outcomes of intraoperative colonic irrigation（IOCI） in the elderly of left colorectal cancer with colonic obstruction. Methods Fifty-six patients aged more than 70 years old were operated for colorectal cancer accomanied by colonic obstruction, who were assigned into two groups of A（IOCI＋primary resection and anastomosis） and B（left half colon or rectum resection＋colostomy）. The anastomotie leakage in group A was observed and the operation time,postoperative infection, hospital stay and the death rate were compared between two groups. Results Postoperative anastomotic leakage occurred in 1（4. 2%） case in group A. The operation time was longer in group A than that in group B[（175±14.5） rain vs. （143±12.7） min）]（P〈0. 05）. There were no significantly differences in postoperative infection, hospital stay and death rate （P〉0. 05）. Conclusion With strict control of surgical indications, IOCI ＋ primary resection and anastomosis are safe and feasible in the elderly of left colorectal cancer with colonic obstruction.

关 键 词：结肠灌洗 结直肠癌 肠梗阻 老年 

分 类 号：R735[医药卫生—肿瘤]