结肠癌合并肠梗阻手术治疗分析

Analysis of the Surgical Treatment for Colon Cancer Complicated with Intestinal Obstruction

目的对结肠癌合并肠梗阻患者进行手术治疗临床疗效进行分析和研究。方法整群选择2013年6月—2015年3月在该院接受治疗的结肠癌合并肠梗阻患者150例,随机分为观察组和对照组,在随机分组后,因病情需要,将存在大出血、肠穿孔的5名患者放入对照组。最后确定观察组90例,对照组60例。对观察组患者采用一期手术治疗,对对照组患者采用分期手术治疗。观察比较患者的住院时间、费用及并发症情况。结果和对照组平均住院时间（22±4.6）d相比,观察组患者平均住院时间明显较短,仅（15±3.5）d,差异具有统计学意义（t=2.327,P=0.038〈0.05）;对照组平均住院费用为（2.61±0.37）万元,而观察组为（2.14±0.31）万元,费用更低,差异具有统计学意义（t=5.792,P〈0.01）。另外,对于术后并发症发生率,观察组患者为3.3%,明显小于对照组的15%。两组差异具有统计学意义（χ^2=6.658,P=0.0099〈0.01）。结论对于结肠癌合并肠梗阻患者,和多期手术方案相比,采用一期切除治疗手术具有效果更好,患者恢复快、并发症更少等明显的优点,值得在临床上进一步推广应用。

Objective To analyze and investigate the clinical effect of the surgical treatment for colon cancer complicated with intestinal obstruction. Methods 150 patients with colon cancer complicated with intestinal obstruction who were treated in our hospital from June 2013 to March 2015 were selected and randomly divided into the observation group（90 cases） and the control group（60 cases, including 5 cases with hemorrhea or enterobrosis added due to the need of disease after the randomization）. The observation group were treated by one-stage operation while the control group by staging operation. The hospital stay and cost of hospitalization and incidence of complications of the two groups were observed and compared.Results Compared with the control group, the observation group had much shorter average hospitalization stay [（15±3.5）d vs（22±4.6）d], the difference was statistically significant（t=2.327, P=0.038〈0.05）. The observation group had much less mean hospitalization cost than the control group[（2.61±0.37） ten thousand yuan vs（2.14±0.31） ten thousand yuan], the difference was statistically significant（t=5.792, P0.01）. Additionally, the observation group had much lower incidence of postoperative complications than the control group（3.3% vs 15%）, the difference was statistically significant（χ~2=6.658,P=0.0099〈0.01）.Conclusion For patients with colon cancer combined with intestinal obstruction, one-stage surgery has many obvious advantages, such as better effect, quicker recovery and fewer complications and so on compared with the staging operation,so one-stage surgery is worthy of further popularization and application in clinic.