胃肠道恶性肿瘤术后肠梗阻86例临床分析

Clinical Analysis of 86 Cases of Postoperative Intestinal Obstruction after Gastrointestinal Cancer Operation

目的探究胃肠道恶性肿瘤术后肠梗阻的临床特点及治疗方法。方法回顾性分析2013年6月至2015年6月皖南医学院第一附属医院胃肠外科收治的86例胃肠道恶性肿瘤术后肠梗阻患者的临床资料。结果因肿瘤原因引起肠梗阻者占38.4%(33/86),非肿瘤性原因者占61.6%(53/86);肿瘤性肠梗阻多发生在距首次手术6个月以后,而非肿瘤性肠梗阻多发生在6个月以内(P<0.01);病理诊断为低分化者和TNM分期为III、IV期者多发生肿瘤性肠梗阻(P<0.05)。结论梗阻时间和原发肿瘤分化、分期可作为判断胃肠道恶性肿瘤术后肿瘤性肠梗阻的临床指标。在临床工作中,应提高对此类肠梗阻原因的分析能力,把握再手术的时机及选择适当的手术方式。

Objective To investigate the clinical characteristics and therapy of postoperative intestinal obstruction after gastroin-testinal cancer operation. Methods A retrospective study was conducted to analyze the clinical data of 86 cases of postoperative intes-tinal obstruction after gastrointestinal cancer operation admitted into the Department of Gastrointestinal Surgery of the First Affiliated Hospital of Wannan Medical College from June 2013 to June 2015. Results The cases of postoperative intestinal obstruction caused by？ tumors accounted for 38. 4%, those not caused by tumors 61. 6%. Most of postoperative intestinal obstruction caused by tumors occurred 6 months after the first operation, those not caused by tumors within 6 months （ P〈0. 01 ） . Most of the patients who were poorly differentiated by the pathological diagnosis and those whose TNM stages were III or IV suffered from postoperative intestinal ob-struction caused by tumors （ P〈0. 05 ） . Conclusions The time when intestinal obstruction occurs , the differentiation of primary tumors and the TNM stage can be regarded as clinical？ indicators of postoperative intestinal obstruction caused by？ tumors after gastro-intestinal cancer operation. In clinical practice, we should improve our analysis ability of the causes of intestinal obstruction and choose the right time for reoperation and appropriate therapy.