结肠支架联合外科手术治疗急性梗阻性结直肠癌的效果  

The Effect of Colon Stent Combined with Surgical Treatment for Acute Obstructive Colorectal Cancer

作　　者：迟宝欣 常志恒 韩熙渊 党彤[4] 汤泊夫 王觅柱[4] 刘璐[4] CHI Baoxin;CHANG Zhiheng;HAN Xiyuan;DANG Tong;TANG Bofu;WANG Mizhu;LIU Lu(Graduate School of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040,China;不详)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头014040 [2]呼和浩特市第一医院消化内科,内蒙古呼和浩特010020 [3]内蒙古科技大学包头医学院第二附属医院普外科,内蒙古包头014030 [4]内蒙古科技大学包头医学院第二附属医院消化内科,内蒙古包头014030

出　　处：《中国医学创新》2025年第1期25-30,共6页Medical Innovation of China

基　　金：包头市卫生健康科技计划项目(wsjkkj2022055)。

摘　　要：目的:对比内镜下结肠支架置入作为手术过渡联合外科手术与单纯外科手术两种方式治疗急性梗阻性结直肠癌的临床效果,探讨结肠支架在治疗急性梗阻性结直肠癌的有效性和安全性。方法:本文为回顾性研究,选择2020年1月—2023年9月就诊于内蒙古科技大学包头医学院第二附属医院因急性梗阻性结直肠癌接受结肠支架置入后进行择期手术的50例患者(支架组),并对技术成功率、临床成功率及支架相关并发症进行了观察,并与同期急性梗阻性结直肠癌行外科手术的50例患者(外科组)比较,观察腹腔镜手术率、手术用时、术后肠道恢复时间、肿瘤一期切除吻合率、术后并发症发生率及住院花费等指标。结果:支架组技术成功率和临床成功率分别为100%和96%。与外科组相比,支架组患者在腹腔镜手术率、一期切除吻合率方面有明显优势(P<0.05);同时,支架组在手术用时、术中出血量、术后肠道恢复时间及手术相关并发症发生率上均显著优于外科组(P<0.05)。支架组患者住院花费高于外科组患者(P<0.05)。结论:结肠支架置入术是急性梗阻性结直肠癌安全和可靠的治疗手段。与外科手术相比,支架置入术作为择期手术的过渡治疗有助于提高急性梗阻性结直肠癌患者选择腹腔镜微创手术的可能性,同时缩短手术时间,降低患者术后并发症的风险,提高了一期切除吻合率,虽住院费用较高,但也为患者治疗提供了一种新的选择。Objective:To compare the clinical efficacy of endoscopic colon stent placement as a transitional surgery combined surgery between simple surgery in the treatment of acute obstructive colorectal cancer,and to explore the effectiveness and safety of colon stent placement in the treatment of acute obstructive colorectal cancer.Method:This article was a retrospective study.50 patients(stent group)who underwent elective surgery for acute obstructive colorectal cancer after receiving colon stent placement at the Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from January 2020 to September 2023 were selected.The technical success rate,clinical success rate,and stent related complications were observed,and compared with 50 patients(surgical group)who underwent surgery for acute obstructive colorectal cancer during the same period.Indicators such as laparoscopic operation rate,surgical time,postoperative intestinal recovery time,one-stage resection and anastomosis rate,incidence of postoperative complications,and hospitalization expenses were observed.Result:In the stent group,the technical success rate and clinical success rate for patients with acute obstructive colorectal cancer were 100%and 96%,respectively.Compared with the surgery group,patients in the stent group had significant advantages in operation rate of laparoscopy and one-stage resection and anastomosis rate(P<0.05).Additionally,the stent group showed significant superiority in surgery time,intraoperative blood loss,postoperative bowel recovery time and operation-related complication rate compared to the surgery group(P<0.05).Hospitalization cost in the stent group for patients was higher than that in the surgery group(P<0.05).Conclusion:Colonic stent placement is a safe and reliable treatment for acute obstructive colorectal cancer.Compared with surgical treatment,stent placement as a bridging procedure before elective surgery helps increase the likelihood of acute obstructive colorectal cancer pati

关 键 词：急性梗阻性结直肠癌 结肠支架 并发症 

分 类 号：R735.34[医药卫生—肿瘤]