结肠镜下支架置入治疗结直肠恶性梗阻的效果观察

Effect observation of stent implantation through colonoscope for colorectal malignant obstruction

目的观察结肠镜下支架置入治疗结直肠恶性梗阻的临床效果。方法选择2009年1月～2012年6月本院收治的结直肠恶性梗阻行结肠镜下支架置入术的患者15例为观察组，选择同期行外科手术治疗的结直肠恶性梗阻患者15例为对照组；分析观察组患者的金属支架置人成功率与梗阻改善情况，比较两组患者平均生存时间和生活质量。结果观察组金属支架置入成功率为100％，梗阻改善情况满意；两组患者的平均生存时间对比，差异无统计学意义（P〉0.05），但是观察组患者术后并发症显著少于对照组（P〈0.05）。结论结肠镜下支架置入术能够有效、快速地解除结直肠梗阻，操作简易，重复性强，能保持正常生理状态的肛门排便，易被患者接受，且患者并发症少，住院时间短，耐受性好，值得临床推广应用。

Objective To observe the clinical effect and prognosis of stent implantation through colonoscope for col- orectal malignant obstruction. Methods 15 patients with colorectal malignant obstruction received stent implantation through colonoscope from January 2009 to June 2012 were retrospectively selected as observation group, another 15 patients underwent surgical operation during the same period were simultaneously selected as control group. The success rate of stent implantation and improvement of obstruction in observation group were analyzed, and the average survival time and life quality of patients in two groups were compared. Results In observation group, the success rate of stent implantation was 100%, and the improvement of obstruction was satisfactory. The comparison of average sur- vival time in both groups showed no significant difference （P〉0.05）. The postoperative complications of patients in observation group were significantly less than those of control group （P〈0.05）. Conclusion The stent implantation through colonoscope can effectively and quickly relieve colorectal obstruction, with simple operation and strong repeatability, it can maintain normal physiological state of anus bowel movements, is easily accepted by patients, and patients with fewer complications, shorter hospitalization time, good tolerance, so it is worthy of clinical popularization and application.