急诊手术和择期手术治疗梗阻性结肠癌的临床效果和安全性

The clinical effect and safety of emergency surgery and elective surgery treatment for obstructive colon cancer

目的 探讨临床中梗阻性结肠癌患者实施急诊手术与择期手术治疗的临床效果与安全性.方法 选择2007年1月～2011年12月山东淄博市第一医院普外二科梗阻性结肠癌患者90例为研究对象,将其按照手术时机分为择期手术组和急诊手术组,每组各45例,急诊手术组患者在诊断之后直接实施手术治疗,择期手术组患者先给予保守治疗,并在病情缓解后择期手术治疗,观察两组的临床治疗效果.结果 择期手术组结肠癌切除Ⅰ期吻合术率为91.1％,急诊手术组结肠癌切除Ⅰ期吻合术率为55.6％,择期手术组明显高于急诊手术组,差异有统计学意义（P＜0.05）.择期手术组的肺部感染、吻合口痿和切口感染发生率（2.2％、2.2％、2.2％）均明显低于急诊手术组（13.3％、15.6％、26.7％）,两组相比,差异均有统计学意义（均P＜0.05）.结论 临床中对于梗阻性结肠癌患者实施择期手术治疗的一次性根除率较高,并且其术后并发症也比较少,治疗安全性更高,值得临床中应用与推广.

Objective To investigate the clinical effect and safety of obstructive colon cancer patients undergoing elec tive surgery and emergency surgery. Methods 90 cases with obstructive colon cancer from January 2007 to December 2011 in the Second General Surgery Department of First Hospital of Zibo City were selected as the research objects, and they were divided into elective surgery group and emergency operation group according to the operation time, with 45 cases in each group. Operation group were given the direct implementation of emergency operation treatment after diagnosis, elective surgery group were given the conservative treatment, and in remission after elective operation treat- ment, the clinical therapeutic effect of two groups were observed. Results The rate of colon cancer excision period anastomosis in the elective surgery group was 91.1%, emergency surgery group was 55.6%, elective surgery group was significantly higher than the emergency surgery group, the difference was statistically significant （P 〈 0.05）. the rate of lung infection, anastigmatic fistula and wound infection in elective surgery group （2.2%, 2.2%, 2.2% ） were all signifi-cantly lower than those in emergency operation group （13.3%, 15.6%, 26.7%）, the differences of two gkvqs were statis- tically significant （P 〈 0.05）. Conclusion For clinical obstructive colon cancer patients, the elective surgical disposable eradication rate is higher and fewer postoperative complications, treatment and more secure, worthy of clinical applica tion and promotion.