结直肠癌伴穿孔的诊治体会

Treatment of Perforating Colorectal Carcinoma

目的：探讨有效地预防结、直肠癌伴穿孔的发生及合理治疗结、直肠癌伴穿孔的方法。方法：用X2检验分析742例患者的5年生存率与其中的11例伴穿孔患者的5年生存率（所有病例均随访5年以上）。结果：全部742例结、直肠癌患者的5年生存率为58.6％。11例伴穿孔患者的5年生存率仅为18.2％。4例伴急性穿孔患者中的3例有诱发穿孔的因素。穿孔的部位大多发生在左侧结肠；其病理类型多数为粘液腺癌。结论:结、直肠癌伴穿孔患者的预后很差，在诊治过程中避免医源性的诱发穿孔因素值得重视；特别是结、直肠癌伴不全性梗阻时，要慎重选择检查手段及清洁肠道准备的方法。

Purpose:To study the method of prevention and treatment of perforation in colorectal cancer patients. Method:The five-year survival rates of 742 cases and 11 Perforation patients among the 742 cases were analyzed with X2 test. All these cases were followcd up for more than five years. Results: The five-year survival rate of all these cases was 58. 6%, while that of eleven patients with perforation was only 18. 2 %. Three of four acute perforating cases had inductive factors. Perforation was located at left, and most of the cases were mucoid adenocarcinoma. Conclusion: The prognosis of colorectal cancer patients with per foration was poor. We should pay attention to inductive factors of perforation in the process of therapy. While comming into colorectal patients with incomplete obstruction, we should choose suitable means of examination and cleanning the bowel.