梗阻性结直肠癌自膨式金属支架置入手术治疗的临床研究  

Clinical Study of Self-expandable Metal Stent in the Treatment of Obstructive Colorectal Cancer

作　　者：周珩 

机构地区：[1]北京中医医院顺义医院,101300

出　　处：《实用癌症杂志》2015年第5期717-719,共3页The Practical Journal of Cancer

摘　　要：目的自膨式金属内支架术对梗阻性结直肠癌的疗效。方法 50例梗阻性结直肠癌患者,按照治疗方式的不同将患者分为两组,观察组为选择自膨式金属支架解除梗阻性结直肠癌的患者,对照组为采用姑息性手术治疗的患者,两组各25例。对比观察两组手术平均时间、平均出血量、术后并发症、Ⅰ期吻合率、术后恢复情况(住院时间、术后排气时间、术后腹腔引流时间)。结果观察组手术时间为(5.54±1.51)h,术中出血量为(76.20±46.71)ml,对照组平均为(4.81±1.40)h,术中出血量平均为(150.81±125.32)ml,观察组手术时间略长,但出血量较少,对照组出血量相对较多。对照组术后并发症发生率为32.0%,高于观察组(4.0%),观察组23例患者梗阻症状在放置支架后48 h内缓解,另外2例患者转开腹手术梗阻症状也均消失。25例患者术后3个月均Ⅰ期吻合,高于对照组的Ⅰ期吻合率(64.0%)。观察组平均住院时间为[(10.16±2.80)d],短于对照组[(16.42±7.13)d]。术后[(3.31±1.31)d]排气,恢复胃肠蠕动时间相对对照组[(5.61±2.1)d]较短,观察组术后腹腔引流时间平均[(7.16±2.52)d],低于对照组腹腔引流时间[(10.01±2.63)d],两组上述指标比较差异均有统计学意义(P<0.05)。随访1年,对照组死亡1例,观察组未发现死亡病例。结论自膨式金属内支架术作为梗阻性结直肠癌的术前准备疗效确切。Objective To study the curative effect of self-expandable metal stent in the treatment of obstructive colorectal cancer. Methods 50 patients with obstructive colorectal cancer were divided into 2 groups,each with 25 cases. The treatment group received self-expandable metal stent,and the control group received palliative surgery. Operation time,average blood loss,postoperative complications,stage coincidence rate,postoperative recovery( length of hospital stay,postoperative exhaust time,postoperative abdominal drainage time) were compared. Results In the observation group,operation time was( 5. 54 ± 1. 51) h,intraoperative blood loss was( 76. 20 ± 46. 71) ml,in the control group,operation time was( 4. 81 ± 1. 40) h,intraoperative blood loss was( 150. 81 ± 125. 32) ml. In the observation group,operation time was longer,blood loss was less,in the control group,blood loss was relatively greater. Incidence of postoperative complications in the control group was 32. 0%,which was higher than that of the observation group( 4. 0%). In the observation group,23 cases relieved within 48 h after stent implantation,2 cases transfer laparotomy obstruction symptoms disappeared,stage coincidence rate after 3 months of the observation group were higher than that of the control group( 64. 0%). The average length of hospital stay of the observation group was( 10. 16 ± 2. 80) d,which was shorter than that of the control group( 16. 42 ± 7. 13) d. Postoperative exhaust time of the observation group was( 3. 31 ± 1. 31) d,which was shorter than that of the control group( 5. 61 ± 2. 1) d. Postoperative abdominal drainage time of the observation group was( 7. 16 ± 2. 52) d,which was shorter than that of the control group( 10. 01 ± 2. 63) d,there had significant difference( P <0. 05). During 1-year follow-up,the control group had 1 death,and the observation group had no death. Conclusion Self-expandable metal stent in the treatment of obstructive colorectal cancer is effective.

关 键 词：梗阻性结直肠癌 自膨式金属内支架术 急诊手术 

分 类 号：R735.34[医药卫生—肿瘤]