结肠癌并急性肠梗阻40例临床分析

Clinical Analysis for 40 Cases with Acute Bowel Obstruction in Patients with Colon Cancer

目的探讨结肠癌并急性肠梗阻的外科治疗效果。方法对40例结肠癌并急性肠梗阻患者的临床资料进行回顾性分析。结果40例病例中,20例采用Ⅰ期结肠造瘘术缓解肠梗阻、Ⅱ期手术根治+造瘘肠管还纳术,20例采用Ⅰ期手术根治+结肠造瘘术、Ⅱ期造瘘肠管回纳术。结论Ⅰ期手术根治+结肠造瘘术、Ⅱ期造瘘结肠回纳术治疗乙状结肠癌合并肠梗阻在手术根治率、术后局部复发率及3年生存率、5年生存率方面优于第一种手术方式。

Objective To investigate the diagnosis and management of acute bowel obstruction in ptients with colon cancer. Methods 40 cases of acute bowel obstruction in patients with colon cancer were analyzed retrospectively. All patients were treated by surgical management. Results 37 cases were succeeded. 3 cases were dead within postoperative period：two cases died from pulmonry infection and cardiac failure, one case died from anasto-mosis fistula, sepsis and infective shock. Postoperative complications were found in 21 cases, 8 cases with pulmonary infection,4 cases with incision infetion and heart-lung-liver functional defect respectively,2 cases with anastomosis fistula and disruption wound respectively, 1 case with abdominal infection. Conclusion Prior to operation,we should carry ouintegrated judgment,grasp operative indications and methods, and attach importance to the managemen of perioperative period.