腹腔镜手术与开腹手术治疗结直肠癌的临床效果比较

Clinical comparative study of laparoscopy and laparotomy in the treatment of colorectal cancer

目的 比较腹腔镜手术与开腹手术分别应用于结直肠癌的治疗效果.方法 选取2015年1月至2017年1月浙江省中医院安吉分院收治的结直肠癌患者110例为研究对象,按照随机数字表法分为研究组和对照组两组,每组55例,研究组使用腹腔镜手术的方式治疗结直肠癌;对照组使用开腹手术的方式治疗结直肠癌.观察比较两组患者的满意程度、手术持续时间、术中出血量、术后肛门排气时间、术后住院时间及术后并发症.结果 研究组手术时间、术中出血量、术后肛门排气时间、术后住院时间分别为（153.5±20.3）min、（159.7±20.6）mL、（2.5±1.6）d、（8.3±2.1）d,均优于对照组的（124.6±18.7）min、（198.6±25.7）mL、（3.7±1.2）d、（12.2±3.2）d,差异均有统计学意义（t=16.544、22.164、10.598、12.336,均P〈0.05）;研究组并发症发生率为12.7％,显著低于对照组的36.4％（χ2=8.617,P=0.029）;研究组在医疗费用、生活质量、术后生存率等与对照组差异均有统计学意义（χ2=9.641、10.446、16.318,均P〈0.05）.结论 结直肠癌患者的腹腔镜治疗方式比开腹手术治疗方式的临床效果好,恢复时间短,患者满意率高.

Objective To compare the effect of laparoscopic surgery and open surgery in the treatment of colorectal cancer.Methods From January 2015 to January 2017,110 patients with colorectal cancer in Anji Branch of Zhejiang Traditional Chinese Medicine Hospital were selected and randomly divided into study group and control group according to the digital table,with 55 cases in each group.The study group received laparoscopic surgery,the control group was given open surgery.The patients＇satisfaction rate,surgical duration,intraoperative bleeding,postoperative anal exhaust time,postoperative hospitalization time and postoperative complications were observed and compared.Results The operative time,intraoperative bleeding,postoperative anal exhaust time,postoperative hospitalization time of the study group were（153.5 ±20.3）min,（159.7 ±20.6）mL,（2.5 ±1.6）d,（8.3 ±2.1）d,respectively,which were significantly better than those of the control group [（124.6 ±18.7）min,（198.6 ± 25.7）mL,（3.7 ±1.2）d,（12.2 ±3.2）d]（t=16.544,22.164,10.598,12.336,all P〈0.05）.The incidence rate of complications in the study group was 12.7%,which was significantly lower than 36.4%in the control group（χ2 =8.617,P=0.029）.There were statistically significant differences in medical cost,life quality,postoperative survival rate between the two groups（χ2 =9.641,10.446,16.318,all P 〈0.05）.Conclusion The clinical effect of laparoscopic treatment for patients with colorectal cancer is better than abdominal operation,the recovery time is short,and the patients＇satisfaction rate is high.