结直肠癌合并肠梗阻的临床治疗观察

Clinical observation of treatment of colorectal cancer with obstruction

目的探讨不同治疗方式对结直肠癌合并肠梗阻患者的治疗效果。方法左半结肠癌并肠梗阻(LCCO)行I期手术患者26例为急诊组,基于内支架植入术的LCCO患者32例为择期组。急诊组于24 h内手术17例,24～48 h内手术9例。择期组患者在造影剂监控下置入自膨式金属支架后,分别于5～8 d内行I期手术。结果择期组患者术后并发伤口感染(9.38%)、吻合口漏(6.25%)、肺炎(3.13%)及深静脉血栓(3.13%)明显少于急诊组患者,差异有统计学意义(P<0.05)。择期组患者住院时间(24.1±3.4)d明显短于急诊组患者,差异有统计学意义(P<0.05),且生存时间(26.3±6.7)月明显长于急诊组,差异有统计学意义(P<0.05)。结论应用内支架置入处理急性LCCO,可以减少术后并发症,并可能延长患者生存时间。

Objective To study the efficacy of different treatment for coloreetal cancer. Methods We selected 26 patients with lett -sided colorecta] cancer（LCCO） with obstruction who needed emergency operation as emergency group, and 32 patients with left -sided eolorectal cancer who accepted internal stent implantation first, and then accepted elective surgery as elective group. The 17 patients had e-mergency operation within 24 hours, while 9 patients had emergency operation within 24 to 48 hours of emergency group. The patients of elective group accepted intestinal stent placement, and then received treatment by stage I operation within 5 to g days. Results Wound infection （9.38%）, anastomotic dehiscence（6.25% ）, pneumonia（3.13% ） and deep venous thromobosis （3.13%） of elective group patients were less than those of emergency group （ P 〈 0. 05 ）. The length of patient stay （24.1 ± 3.4 days） was shorter （P 〈 0. 05 ） and the time to live （26.3 ± 6.7 months） was longer than that of emergency group （ P 〈 0.05 ）. Conclusion Implanting internal stent could effectively remove the obstruction of LCCO, reduce postoperative complications, and prolong the surival time of patients possibly.