支架置入术治疗晚期结直肠癌合并急性肠梗阻的临床疗效

Stent placement for advanced colorectal cancer with acute intestinal obstruction

目的:探讨支架置入术对肿瘤已经广泛转移的晚期结直肠癌合并急性肠梗阻患者的疗效。方法:回顾性分析2005年3月—2011年9月期间收治的67例肿瘤广泛转移的晚期结直肠癌合并急性肠梗阻患者资料,其中30例行支架置入治疗(支架置入组)以及37例行常规急诊手术治疗(常规手术组),比较两组相关临床指标。结果:与常规手术组比较,支架置入组的手术成功率(86.7%vs.97.3%),手术时间(4.32 h vs.4.78 h),术后30 d内病死率(0.0%vs.11.1%)的均无统计学差异(均P>0.05),但术中出血量(76.6 mL vs.274 mL),住院时间(6.7 d vs.15.5 d),总并发症的发生率(19.2%vs.52.8%)均明显减少(均P<0.05);支架置入组与常规手术组中位生存期(11.4个月vs.10.7个月)差异无统计学意义(P>0.05)。结论:支架置入术在治疗直肠癌合并的急性肠梗阻疗效确切,且更安全、可靠,推荐临床应用。

Objective： To investigate the efficacy of stent placement for acute intestinal obstruction combined with advanced colorectal cancer and widespread metastases. Methods： The clinical data of 67 patients with acute intestinal obstruction and colorectal cancer with widespread metastases treated from March 2005 to September 2011 were retrospectively analyzed. Of them, 30 cases received stent placement （stent placement group） and 37 cases underwent conventional emergency surgery （conventional surgery group）, qhe clinical variables between the two groups of patients were compared. Results： In stent placement group, compared with conventional surgery group, the surgical success rate （86.7% vs. 97.3%）, operative time （4.32 h vs. 4.78 h） and postoperative mortality within 30 days （0.0% vs. 11.1%） showed no statistical difference （all P〉0.05）, but the intraoperative blood loss （76.6 mL vs. 274 mL）, length of hospital stay （6.7 d vs. 15.5 d） and overall incidence of complications （19.2% vs. 52.8%） were significantly reduced （all P〈0.05）. There was no significant difference in median survival time （11.4 months vs. 10.7 months） between stent placement group and conventional surgery group （P〈0.05）.Conclusion： Stent placement has demonstrable efficacy in treatment of acute intestinal obstruction combined with advanced colorectal cancer, with better curative effect, and is safe and more reliable, so it is recommended to be used in clinical practice.