择期手术治疗梗阻性结肠癌实效性及安全性研究

Clinical effect and safety evaluation of elective surgery applying in obstructive colon cancer

目的：探讨择期手术治疗梗阻性结肠癌患者的临床效果，为临床选择手术时机提供参考。方法选择70例梗阻性结肠癌患者，根据患者手术时机分为对照组和观察组，各35例，对照组在患者诊断后便实施手术，观察组诊断后首先实施保守治疗，再择期对患者实施手术治疗（要考虑到保守的成功率问题，如胃肠减压等保守治疗不成功的病例需从观察组剔除，急诊手术）。对比两组患者治疗效果以及手术安全性。结果观察组患者Ⅰ期吻合术比率91．43％（32／35），明显高于对照组的54．29％（χ2＝9．456，P ＝0．001）；观察组回结肠吻合术、造口术发生率为2．86％、5．71％，低于对照组（χ2＝12．328，P ＝0．000；χ2＝7．983，P ＝0.003）；观察组共5例患者发生6例次并发症，发生率14．29％，对照组20例患者发生25例次并发症，发生率57．14％，两组差异有统计学意义（χ2＝8．885，P ＝0．002）。结论择期手术治疗应用于梗阻性结肠癌患者可以取得更好地一次性根除效果，且安全性高，临床可考虑优先选择该方案。

Objective To investigate the clinical effect and safety of elective surgery applying in obstructive colon cancer,to provide a reference for clinical surgery.Methods 70 patients with obstructive colon cancer were selected,they were divided into control group and observe group,35 cases in each group.Surgery was used right after patients were diagnosed in the control group,conservative treatment was used in the observation group before surgery. The clinical effect and safety were compared between the two groups.Results The rate of colon cancer excisionⅠperiod anastomosis in the observation group was 91.43% （32 /35 ）,which was higher than the control group （54.29%）,the difference was statistically significant（χ2 =9.456,P =0.001）.The incidence rates of ileocolic anas-tomosis and colostomy of the observation group were 2.86%,5.71%,which were lower than those of the control group,the differences were statistically significant（χ2 =12.328,P =0.000;χ2 =7.983,P =0.003）.5 patients of the observation group had 6 complications,the incidence rate of complication was 14.29%,20 patients of the control group had 25 complications,the incidence rate of complication was 57.14%,the difference was statistically significant （χ2 =8.885,P =0.002）.Conclusion Elective surgical disposable eradication rate is higher applying in obstructive colon cancer patients with good safety,which could be a priority in clinical application.