以急腹症为表现的结肠癌临床诊断及治疗探讨

The Analysis of Clinical Diagnosis and Treatment for the Colon Cancer which Performanced for Acute Abdominal Disease

目的探讨以急腹症为表现的结肠癌临床诊断及治疗方法。方法以2009年1月—2011年12月期间该院收治的56例以急腹症为表现的结肠癌患者为研究对象,对其临床资料进行回顾性分析,分析其临床表现,均给予急诊腹部X线平片、超声或CT扫描检查,根据病变部位、术中所见及临床分期采取不同的手术方式。结果 56例患者均确诊为结肠癌,其中27例表现为急性肠梗阻,17例表现为急性阑尾炎,8例表现为肠穿孔,4例表现为消化道出血;给予结肠切除并I期吻合42例,行姑息性肿瘤切除并造瘘6例,单纯造口姑息术8例;术后患者恢复良好,3年生存率为91.07%(51/56),5年生存率为41.07%(23/56)。结论以急腹症为表现的结肠癌容易发生误诊,术前应注意鉴别诊断,手术治疗应注意术式的选择,术中给予肠道灌洗、术后全肠外营养等治疗方法可以提高治疗效果,延长患者的生存时间。

Objective To explore the methods of diagnosis and treatment for the Colon cancer which performanced for acute abdominal disease.M ethods 56 Colon cancer cases who performanced for acute abdominal disease were put as the the research object,their clinical data were reviewed retrospectively,their clinical manifestations were analysed,and were all examined by the emergency abdominal X-ray ultrasound or CT scans,were taked with different operation methods by the lesions area,operative findings and clinical stages.Result 56 patients were all diagnosed as Colon cancer,27 cases＇ clinical symptoms were acute intestinal obstruction,17 cases clinical symptoms were acute appendicitis,8 cases＇ clinical symptoms were enterobrosis,4 cases＇ clinical symptoms were gastrointestinal bleeding.42 cases were treated by colectomy and stage Ⅰ anastomosis.8 cases were treated by palliative gastrectomy and colostomy,All patients recovered well after operation,3 years of survival rate was 91.07%,5 years of survival rate was 41.07%.Conclusion The diagnosis was difficult because the Colon cancer performanced for acute abdominal disease.Preoperative diagnosis should be paid more attention to,and the right operation methods should be choosed,the treatment of colon irrigation and total parenteral nutrition could improve curative effect,extend the life time of patient.