Ⅰ期肿瘤切除肠吻合术联合术中全结肠灌洗在左半结肠癌并梗阻患者中应用及效果

Application of intraoperative colonic irrigation in colon obstruction caused by left colon cancer

目的探讨I期肿瘤切除肠吻合术联合术中全结肠灌洗在左半结肠癌并梗阻患者中应用及效果。方法选取2010年12月—2012年12月收治我院左半结肠癌并肠梗阻患者50例,按照数字随机法将患者随机分为两组,观察组25例,入院后行I期肿瘤切除吻合术,进行全结肠灌洗。对照组25例行分期吻合术治疗。观察两组患者吻合口瘘发生率、切口感染情况,以及患者住院时间及术后质量比较。结果两组患者均痊愈出院,但观察组术后并发症发生率24.0%,显著低于对照组的36.0%,两组相比,差异具有统计学意义,P<0.05;且观察组患者住院时间为(16.5±4.5)d,明显短于对照组的(26.7±4.3)d,差异具有统计学意义。出院随访后生活质量明显高于对照组,两组相比,差异具有统计学意义,P<0.05。结论左半结肠癌合并肠梗阻I期吻合术治疗效果安全可靠,术中全结肠灌洗是治疗成功的关键。

Objective To analyze the value of intraoperative colonic irrigation in one-stage resection and anastomosis for colon obstruction caused by left colon cancer. Methods 50 patients in Guangde People＇ s Hospital from December 2010 to December 2012 were divided into two groups by random. 25 cases of the observation group were treated by hospital stage I tumors resection and anastomosis ,full-colon- ic irrigation. 25 patients of the control group were treated by II stage anastomosis. The incidence of anastomotic leakage,wound infection, and hospitalization time and postoperative＇ quality comparison were observed. Results Two groups of patients were cured. The incidence of postoperative complications in the observation group was 24.0% , significantly lower than 36.0% in the control group, with a statisti- cally significant difference,P 〈 0.05;in observation group hospitalization time was （16.5± 4.5 ） days, significantly shorter than that in the control group, （ 26.7 ±4.3 ） days, with a statistically significant difference. Quality of life after hospital discharge during follow-up was significantly higher in the observation group than the control group, with a statistically significant difference, P 〈 0.05. Conclusions Intraoperative colonic irrigation is safe and reliable in one -stage resection and anastomosis for colon obstruction caused by left colon cancer. Intraoperative colonic irrigation is the key to the success of the operation.