腹腔镜与开腹结肠癌根治术术后并发症的对照研究及分析  

Comparative Research and Analysis of Complications after the Laparoscopic Surgery and Laparotomy Radical Operation for Carcinoma of Colon

作　　者：杨立昌[1] 姬永忠[1] 王建平 

机构地区：[1]兰州军区总医院安宁分院普外科,甘肃兰州730070

出　　处：《中外医疗》2017年第31期16-19,共4页China & Foreign Medical Treatment

摘　　要：目的分析腹腔镜与开腹结肠癌根治术术后并发症以及整体效果,旨意寻找更适合患者的治疗方式。方法方便择取2012年11月—2017年6月该院收治的126例结肠癌者为研究对象。依照就诊单双号顺序,将患者随机平均分为观察组和对照组。每组63例。观察组病患接受腹腔镜手术治疗,对照组病患接受开腹手术。分析术后并发症情况和整体手术效果。结果观察组吗啡使用量、住院天数、镇痛时间、胃肠功能恢复时间、肛门排气时间、住院天数分别为:(10.36±3.22)mg、(17.42±8.21)min、(63.28±32.14)h、(66.23±12.34)h、(8.63±1.21)d;对照组为(18.26±5.13)mg、(32.25±18.52)min、(96.41±33.91)h、(90.12±13.61)h、(11.52±1.36)d;组间数据差异有统计学意义(P<0.05)。观察组住院费用比对照组高(P<0.05)。观察组切口长度较短,手术时间较长,清扫淋巴结个数以及术中出血量为(6.63±2.51)cm、(189.57±13.25)min、(166.39±16.36)mL、(10.25±1.43)个;对照组为(15.29±3.21)cm、(165.36±16.32)min、(212.14±14.52)mL、(14.21±2.27)个,组间数据差异有统计学意义(P<0.05)。相对患者开展为期3~56个月的临床随访,平均时长为(31.25±10.21)个月,所有患者均参与随访,无失访。与对照组相比,观察组出现切口感染以及黏连性肠梗阻比率明显较低(P<0.05)。总并发症发生率较低(P<0.05)。其余种类并发症发生情况差异无统计学意义(P>0.05)。结论对于结肠癌者,根治性手术为主要治疗方式。相较于开腹法而言,腹腔镜法虽说治疗费用和时间均较高,但这种手术方式并发症发生率更低,术后恢复时间段,术中出血量少,安全性更强,有效性更高。患者可结合自身病情和经济实力,择取合适的手术方式接受治疗。Objective To analyze the complications after the laparoscopic surgery and laparotomy radical operation for carcinoma of colon and holistic effect in order to search for the treatment method more suitable for patients. Methods 126 cases of patients with carcinoma of colon admitted and treated in our hospital from November 2012 to June 2017 were convenient selected and divided into two groups with 63 cases in each, the observation group and the control group were respectively treated with laparoscopic surgery and laparotomy radical operation for carcinoma of colon, and the postoperative complicatins and holistic operation effect were analyzed. Results The differences in the morphine usage, length of stay, analgesia time, gastrointestinal function recovery time, anal exhaust time and length of stay between the observation group and the control group were obvious, [(10.36 ±3.22)mg,(17.42 ±8.21)min,(63.28 ±32.14)h,(66.23 ±12.34)h,(8.63 ±1.21)d vs(18.26 ±5.13)mg,(32.25 ±18.52)min,(96.41 ±33.91)h,(90.12 ±13.61)h,(11.52 ±1.36)d](P <0.05), and the hospitalization cost in the observation group was higher than that in the control group(P<0.05),and the differences in the cut length, operation time,lymph node dissection number and intraoperative bleeding amount between the observation group and in the control group were obvious, [(6.63 ±2.51)cm,(189.57 ±13.25)min,(166.39 ±16.36)m L,(10.25 ±1.43) vs(15.29 ±3.21)cm,(165.36 ±16.32)min,(212.14 ±14.52)m L,(14.21 ±2.27)](P <0.05), and the clinical follow-up of 3 ~56 months showed that the average time was(31.25 ±10.21) months, and all patients participated in the follow-up, no one lost to follow up, and the cut infectionand adhesive intestinal obstruction ratios in the observation group were lower(P<0.05), and the total incidence rate of complications was lower(P<0.05), and the difference in the occurrence of complications was not obvious(P>0.05). Conclusion The radical operation for carcinoma of colon patients is the major treatment method, and the incidence rat

关 键 词：腹腔镜 开腹手术 结肠癌根治术 并发症 整体疗效 

分 类 号：R5[医药卫生—内科学]