老年患者应用自膨式金属支架作为结肠癌急性恶性肠梗阻择期手术的临时处理手段的短期评价  

Short⁃term results of self-expandable metallic stent as a temporary approach to elective operation for acute malignant colonic obstruction in elderly patients

作　　者：庄志浩[1] 欧阳秋伟 陶世明[1] 霍景山[1] 吴岷翰[1] 韩新峰[1] 贺友 ZHUANG Zhi-hao;OUYANG Qiu-wei;TAO Shi-ming;HUO Jing-shan;WU Min-han;HAN Xin-feng;HE You(Department of General Surgery,Foshan Hospital of TCM,Foshan,Guangdong 528000,China)

机构地区：[1]佛山市中医院外一科,广东佛山528000

出　　处：《岭南现代临床外科》2020年第4期421-424,430,共5页Lingnan Modern Clinics in Surgery

基　　金：佛山市医学类科技攻关项目(2015AB00345);广东省医学科学技术研究基金项目(A2017609)。

摘　　要：目的评估自膨式金属支架(SEMS)在恶性肠梗阻患者应用价值和分析。方法选择2014年至2017年作者收治的结肠癌伴急性肠梗阻患者的临床资料。包括接受SEMS处理23例(SEMS组),未使用SEMS的急诊手术患者31例(no⁃SEMS组),所有患者获得根治性切除。结果所有患者均获得手术后30天的随访。SEMS组16例采用腔镜下结肠癌根治手术,7例实施开放手术;no⁃SEMS组均为开放手术。SEMS组术后恢复总体较no⁃SEMS组良好,如较短的肠功能恢复时间、较短的肠外营养时间、较短的住院时间和较少的术后并发症总数(均P<0.05)。但SEMS组术前发生1例肠穿孔、2例SEMS移位需要紧急处理。结论针对结肠癌导致的恶性肠梗阻,SEMS内镜结肠支架置入术作为择期手术的桥梁,具有良好的短期效果,但是应该尽量避免SEMS操作并发症。Objective To evaluate the application value and analysis of self⁃expanding metal stent(SEMS)in patients with malignant intestinal obstruction.Methods The data of colon cancer patients with acute intestinal obstruction admitted by the author from 2014 to 2017 were selected.Twenty three pa⁃tients(SEMS group)received SEMS treatment,and 31 patients(no⁃SEMS group)received emergency surgery without SEMS.All patients underwent radical resection.Results All patients were followed up for 30 days after operation.In the SEMS group,16 cases were treated with laparoscopic radical surgery,and 7 cases were treated with open surgery.All patients in no⁃SEMS group underwent open surgery.The postoperative recovery of SEMS group was better than that of no⁃SEMS group,such as shorter bowel function time,shorter parenteral nutrition time,shorter hospital stay and total postoperative complications.But in the SEMS group,one case of intestinal perforation and two cases of SEMS displacement needed emergency treatment.Conclusion For malignant intestinal obstruction caused by colon cancer,SEMS as a bridge for elective surgery has good short⁃term effect,but we should try to avoid complications of SEMS operation.

关 键 词：结肠癌 急性恶性肠梗阻 自膨式金属支架 结肠癌根治术 

分 类 号：R735.35[医药卫生—肿瘤]