腹腔镜与开腹手术治疗结直肠癌的术后肠梗阻对比探究

Study on Comparison of Laparoscope and Laparotomy in Treatment of Intestinal Obstruction after the Colorectal Cancer Surgery

目的分析腹腔镜与开腹手术治疗结直肠癌的术后肠梗阻的效果。方法将2013年1月—2017年6月,方便选取进入该院的研究对象140例进行回顾性分析,均为结直肠癌患者,根据治疗方式的不同分为对照组(n=70)和观察组(n=70),对照组采用开腹手术治疗方式,观察组采用腹腔镜手术方式,比较两组临床效果。结果对照组术后肠梗阻发生11例(15.71%)、与观察组术后肠梗阻发生2例(2.86%)比较差异有统计学意义(χ~2=6.498,P<0.05)。两组的手术时间差异无统计学意义(P>0.05),对照组术中出血量(148.36±10.75)mL、肛门排气时间(31.69±3.52)h、住院时间(12.07±2.57)d与观察组术中出血量(97.45±12.91)mL、肛门排气时间(24.52±1.14)h、住院时间(6.98±1.92)d比较差异有统计学意义(t=9.238、8.297、7.463,P<0.05)。结论针对结直肠癌患者采用腹腔镜手术可有效减小对患者的损伤,降低术后肠梗阻的发生,降低术中出血量,缩短肛门排气时间与住院时间,值得临床推广与应用。

Objective To analyze the effect of laparoscope and laparotomy in treatment of intestinal obstruction after the colorectal cancer surgery. Methods 140 cases of patients with colorectal cancer in our hospital from January 2013 to June 2017 were convenient selected for review, and divided into two groups with 70 cases in each according to different treatment methods, the control group and the observation group were respectively treated with laparotomy and laparoscope, and the clinical effect was compared between the two groups. Results The difference in the occurrence case of intestinal obstruction after the colorectal cancer surgery between the control group and the observation group was obvious（11 cases vs 2 cases, 15.71% vs 2.86%）, with statistical significance（χ~2=6.498,P〈0.05）, and the difference in the operation time between the two groups was not obvious（P〉0.05）, and the differences in the intraoperative bleeding amount, anal exhaust time, and length of stay between the two groups were obvious, with statistical significance [（148.36 ±10.75）mL,（31.69±3.52）h,（12.07±2.57）d vs（97.45±12.91）mL,（24.52±1.14）h,（6.98±1.92）d]（t=9.238,8.297,7.463,P〈0.05）. Conclusion The laparoscopic surgery in treatment of intestinal obstruction after the colorectal cancer surgery can effectively reduce the injury of patients, reduce the occurrence of postoperative intestinal obstruction, and intraoperative bleeding amount, and shorten the anal exhaust time and length of stay, which is worth clinical promotion and application.