Ⅰ期肠切除吻合术治疗急性梗阻性结肠癌的临床效果分析

Clinical Effects of Intestinal Anastomosis on the Treatment of Acute Obstructive Colorectal Cancer

目的:探讨Ⅰ期肠切除吻合术处理急性梗阻性结肠癌的临床效果,为普外科手术提供参考。方法:对我院2011年4月-2013年11月实施Ⅰ期肠切除吻合术的59例急性梗阻性结肠癌患者的临床资料进行分析,并与择期接受结肠癌根治术的42例患者对比。观察两组患者的平均术中出血量、手术时间、切口长度、切除肿瘤大小、清扫淋巴结数、术后肛门排气、并发症发生率、住院时间及肿瘤复发率等。结果:与根治切除术组比较,Ⅰ期肠切除吻合术组患者的平均手术时间及术中出血量无显著性差异(P>0.05),但肿瘤切除率及淋巴结清扫情况优于根治切除术组,且手术切口小,组间比较差异具有统计学意义(P<0.05)。Ⅰ期肠切除吻合术组患者术后肛门排气时间和下床活动时间早于根治切除术组患者(P<0.05);Ⅰ期肠切除吻合术组患者术后并发症的发生率、肿瘤复发转移率均明显低于根治切除术组患者,差异具有统计学意义(P<0.05);两组患者术后两年的生存率无显著差异(P>0.05)。结论:Ⅰ期肠切除吻合术用于急诊处理急性梗阻性结肠癌具有良好的手术效果,并发症的发生率低,有利于改善患者术后的生存质量。

Objective： To explore the clinical effects of the intestinal anastomosis on the treatment of the acute obstructive colorectal cancer so as to make a reference. Methods： A retrospective analysis was performed about the clinical data of 59 patients with the acute obstructive colorectal cancer who were accepted the intestinal anastomosis in our hospital from April 2011 to November 2013, and another 42 patients who were conducted the selective operation were chosen as the control group. Then the operation time, the blood loss, the incision length, the tumor resections, the rate of recurrence, the incidence of postoperative complications and the hospitalization of patients in the two groups were compared and analyzed. Results： There was no statistically significant difference about the average operation time and the blood loss in the two groups （P〉0.05）; The results of tumor and lymph resections in the anastomosis group were better than those of the control group with statistically significant differences （P〈0.05）; The time of exsufflation and postoperative activities of patients in the anastomosis group was earlier than that of the control group （P〈0.05）; The rates of recurrence and metastasis and the incidence of complications in the anastomosis group were lower than those of the control group with statistically significant differences （P〈0.05）. There was no statistically significant difference about the rate of survival （P〉0.05）. Conclusions： The intestinal anastomosis at stage I is worthy of promoting with the advantages of obvious clinical effects and lower incidence of complications that could improve the life quality of patients.