支架联合腹腔镜Ⅰ期吻合术治疗左结直肠癌合并肠梗阻的应用研究  

Application study of stent combined with laparoscopic Ⅰ anastomosis in treatment of left-sided colorectal cancer with obstruction

作　　者：林木本 孙相钊 陈宗梅[2] 吴培信 朱法清 

机构地区：[1]广东省廉江市人民医院普通外科,广东廉江524400 [2]广东省廉江市人民医院消化内科,广东廉江524400

出　　处：《中国医药科学》2017年第8期196-198,共3页China Medicine And Pharmacy

基　　金：广东省医学科研基金项目(A2014766);广东省湛江市科技攻关计划项目(2016B01069)

摘　　要：目的探讨支架联合腹腔镜Ⅰ期吻合术在左结直肠癌合并肠梗阻中的应用。方法将2013年5月~2016年9月在廉江市人民医院普通外科治疗的64例左结直肠癌合并肠梗阻患者分为A组(32例)和B组(32例)。A组采用支架联合腹腔镜Ⅰ期吻合术,B组采用Hartmann术联合Ⅱ期吻合术。统计两组相关手术数据(术后排气时间和总住院时间等)和并发症发生情况(吻合口瘘和切口感染等),采用χ2检验等分析数据。结果 A组和B组的总住院时间分别为(18.55±2.62)d和(21.27±3.56)d,总住院费用分别为(7.03±0.26)万和(6.07±0.32)万,临床受益评分分别为(9.02±0.78)分和(6.02±1.04)分,失血量分别为(92.26±18.99)mL和(262.58±20.17)mL,手术总并发症发病率分别为6.25%和25.00%,上述指标在两组间的差异均有统计学意义(P<0.05)。结论支架联合腹腔镜Ⅰ期吻合术可以明显减少住院时间、失血量和并发症,并且可使患者的临床受益评分明显提高,值得推荐。Objective To investigate of stent combined with laparoscopic Ⅰanastomosis in treatment of left-sided colorectal cancer with obstruction. Methods 64 patients with left-sided colorectal cancer with obstruction cured in Department of General Surgery of Lianjiang People＇s Hospital from May 2013 and September 2016 were selected as the study objects. They were divided into group A （32 cases） and group B （32 cases）. Patients in group A were treated with stent combined with laparoscopic Ⅰ anastomosis surgery, and patients in group B were treated with Hartmann surgery with Ⅱ stage anastomosis. Data of the surgical data （postoperative exhaust time and total length of stay and so on） and incidence rate of complication （anastomotic fistula and postoperative infection and so on） were collected in the two groups. The data of two groups was compared using chi-square test and so on. Results The total length of hospital stay in group A and group B were （ 18.55 ± 2.62 ）d and （21.27 ± 3.56 ）d. The total hospitalization expenses in group A and group B were （ 7.03 ± 0.26 ） ten thousand and （ 6.07 ± 0.32 ） ten thousand. The clinical benefit score in group A and group B were （ 9.02± 0.78 ） and （ 6.02 ±1.04 ）. The blood loss in group A and group B were （ 92.26 ± 18.99 ） mL and （ 262.58 ± 20.17 ）mL. The incidence rate of total complications of operation in group A and group B were 6.25% and 25.00%. The differences between the two groups were all statistically significant in the above index （P 〈 0.05）. Conclusion The stent combined with laparoscopic Ⅰ anastomosis surgery can obviously reduce the length of stay, blood loss and complications, and it can make the clinical benefit score of patients increased significantly, so it is worth recommending.

关 键 词：结直肠癌 腹腔镜 支架 HARTMANN手术 Ⅰ期吻合术 

分 类 号：R735.3[医药卫生—肿瘤]