老年大肠癌并急性肠梗阻二期手术治疗的临床研究  

A Clinical Study of the Second-stage Surgical Treatment of Elderly Patients with Colorectal Cancer and Acute Intestinal Obstruction

作　　者：傅永安 FU Yong-an(Department of Gastrointestinal Surgery,Quanzhou First Hospital,Quanzhou,Fujian Province,362000 China)

机构地区：[1]泉州市第一医院胃肠外科,福建泉州362000

出　　处：《中外医疗》2020年第35期36-38,共3页China & Foreign Medical Treatment

摘　　要：目的探究腹腔镜手术在老年大肠癌并急性肠梗阻患者中的应用效果。方法回顾该医院在2017年10月—2019年12月时间段收治的65例老年大肠癌并急性肠梗阻患者的临床资料,采用回顾性队列研究方法,依据不同的干预方法归纳为常规手术组和腔镜手术组,两组的病例分别收集28例和37例。两组患者均采取一期肠道支架置入术,待肠梗阻解除后进行手术,其中前者二期手术方法采取常规开腹手术,而后者则在腔镜下手术治疗。对照并分析两组患者的干预效果,对照评价指标主要有患者的一般手术情况、并发症情况。结果腔镜手术组患者的术中出血量、肛门排气时间以及术后住院天数分别为(103.5±59.6)mL、(1.1±0.6)d、(9.8±3.0)d,明显优于常规手术组的(186.3±53.8)mL、(2.7±1.8)d、(15.8±7.1)d,差异有统计学意义(P<0.05);而两组患者的平均手术时间分别为(153.9±39.8)min和(163.1±42.7)min,差异无统计学意义(P>0.05);腔镜手术组患者的切口感染、吻合口瘘以及肺部感染等并发症发生率为10.8%(4/37),与常规手术组的17.9%(5/28)近似,差异无统计学意义(P>0.05)。结论腹腔镜手术可应用于老年大肠癌并急性肠梗阻置入支架后的患者,总体评价较好,能够明显提升患者的治疗效果,改善患者的治疗满意率,具有较高的临床实用性。Objective To explore the effect of laparoscopic surgery in elderly patients with colorectal cancer and acute intestinal obstruction.Methods The clinical data of 65 elderly patients with colorectal cancer and acute intestinal obstruction admitted to the hospital from October 2017 to December 2019 were reviewed.A retrospective cohort study method was used.Based on different intervention methods,they were grouped into routine surgery groups and In the laparoscopic surgery group,28 cases and 37 cases were collected from the two groups.Both groups of patients underwent first-stage intestinal stent implantation,and the operation was performed after the intestinal obstruction was relieved.The second-stage operation of the former was carried out by conventional open surgery,while the latter was treated by laparoscopy.The intervention effects of the two groups of patients were compared and analyzed.The comparative evaluation indexes mainly included the patients'general operation status and complications.Results The intraoperative blood loss,anal exhaust time and postoperative hospital stay of patients in the laparoscopic surgery group were(103.5±59.6)mL,(1.1±0.6)d,and(9.8±3.0)d,respectively,which were significantly better than those in the conventional surgery group(186.3±53.8)mL,(2.7±1.18)d,(15.8±7.1)d,the difference was statistically significant(P<0.05);while the average operation time of the two groups of patients were(153.9±39.8)min and(163.1±42.7)min,with no statistically significant difference(P>0.05);the incidence of complications such as incision infection,anastomotic leakage,and lung infection in the laparoscopic surgery group was 10.8%(4/37),which was compared with 17.9%(5/28)approximately,and the difference was not statistically significant(P>0.05).Conclusion Laparoscopic surgery can be applied to elderly patients with colorectal cancer and acute intestinal obstruction after stent placement.The overall evaluation is good.It can significantly improve the treatment effect of patients and improve the satis

关 键 词：大肠癌并急性肠梗阻 腹腔镜手术 治疗干预 

分 类 号：R735[医药卫生—肿瘤]