162例腹盆腔恶性肿瘤术后肠梗阻临床特点与治疗回顾性分析  

RETROSPECTIVE ANALYSIS OF CLINICAL CHARACTERISTICS AND TREATMENT OF 162 CASES OF POSTOPERATIVE INTESTINAL OBSTRUCTION CAUSED BY ABDOMINAL AND PELVIC MALIGNANT TUMOR

作　　者：李兴海[1] 邵建福 刘仕杰[1] 李萌 杨艳芳 李利坤[2] Li Xinghai;Shao Jianfu;Liu Shijie(Department of General Surgery,Tangshan People's Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市人民医院普外科,063000 [2]唐山市协和医院病理科

出　　处：《中国煤炭工业医学杂志》2020年第4期400-403,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省科技计划项目(编号:20181225)。

摘　　要：目的探讨腹盆腔恶性肿瘤术后发生肠梗阻的特点和治疗方法。方法回顾性分析唐山市人民医院普外科2015年8月—2019年8月收治的162例腹盆腔恶性肿瘤术后发生恶性肠梗阻患者的临床资料。结果腹盆腔恶性肿瘤术后发生肠梗阻分肿瘤性和非肿瘤性肠梗阻,肿瘤性肠梗阻多发生在术后半年以后,非肿瘤性肠梗阻多发生在术后半年内。64例肿瘤性肠梗阻患者按手术方式不同分为姑息性手术组和根治性手术组。患者术后48 h和术后120 h中性粒细胞比率、血清CRP水平比较,姑息组低于根治组(P<0.01);患者术后腹痛缓解的时间,患者术后开始排气、排便的时间、患者的术后在院时间姑息组均低于根治组,差异均有统计学意义(均P<0.05)。结论腹盆腔恶性肿瘤术后出现肿瘤性肠梗阻多发生在半年后,肿瘤性肠梗阻保守治疗无效后行姑息手术可快速地改善胃肠功能,有效地减轻腹痛、腹胀,缩短患者术后在院时间,提高肿瘤患者的生活质量。Objective To investigate the characteristics and treatment of postoperative intestinal obstruction in patients with abdominal and pelvic malignant tumors.Methods The clinical data of one hundred and sixty-two patients with malignant bowel obstruction after operation of abdominal and pelvic malignant tumor in Department of General Surgery of Tangshan People’s Hospital from August 2015 to August 2019 were analyzed retrospectively.Results Postoperative intestinal obstruction of malignant abdominal and pelvic tumors can be classified into neoplastic and non-neoplastic intestinal obstruction.Neoplastic ileus occurred more than half a year after the first operation,while non-neoplastic ileus occurred less than half a year after the first operation.According to different operation methods,64 patients with malignant ileus were divided into palliative operation group and radical operation group.The neutrophil ratio and CRP level in the palliative group were lower than those in the radical group at 48 h and 120 h after surgery(P<0.01),the time of relief of abdominal pain,the time of defecation,the time of defecation and the time of hospitalization in the palliative group were all lower than those in the radical group(P<0.05).Conclusion The majority of malignant bowel obstruction occurred in 6 months after operation.Palliative operation can improve gastrointestinal function quickly,reduce abdominal pain and abdominal distension effectively,and shorten the time in hospital,Improve the quality of life of patients.

关 键 词：恶性肠梗阻 姑息性手术 分析 

分 类 号：R574.2[医药卫生—消化系统]