腹腔镜与开腹结肠癌根治术术后早期炎性肠梗阻的对比分析

Analysis of Comparison of Early Inflammatory Intestinal Obstruction after the Laparoscope and Radical Operation of Colon Cancer

目的对比分析结肠癌患者采用腹腔镜和开腹两种手术方式进行治疗的临床效果,和术后早期炎性肠梗阻情况。方法方便选取2015年6月—2017年6月在该院就诊需要进行根治手术的72例结肠癌患者,以随机分组法分为对照组和治疗组,平均每组36例。对照组实施常规开腹结肠癌根治术治疗;治疗组实施腹腔镜结肠癌根治术治疗。比较两组术后早期炎性肠梗阻发生情况、手术操作时间、术后排气时间、术后住院时间、结肠癌手术效果、手术后不同时间点的VAS疼痛程度评分水平。结果治疗组患者仅有2例术后早期炎性肠梗阻事件发生,少于对照组的8例(χ~2=4.38,P<0.05);手术操作时间(178.34±32.71)min、术后排气时间(32.24±12.72)h、术后住院时间(10.36±2.10)d短于对照组(206.82±42.25)min、(64.39±14.05)h、(16.34±2.58)d(t=29.613 8,30.261 9,13.342 8,P<0.05);结肠癌手术治疗总有效率为91.7%,高于对照组的69.4%(χ~2=4.64,P<0.05);手术后不同时间点的VAS疼痛程度评分水平改善幅度[术后当天(7.31±0.49)分,术后3 d(3.01±0.55)分,t=11.997 6)]大于对照组[术后当天(7.54±0.86)分,术后3 d(5.62±0.63)分,t=11.034 2)](P<0.05)。结论结肠癌患者采用腹腔镜手术方式进行治疗,可以明显降低术后早期炎性肠梗阻事件的发生概率,缩短临床治疗时间,减轻患者疼痛,使治疗效果明显提高。

Objective To compare and analyze the clinical effect of early inflammatory intestinal obstruction after the Laparoscope and Radical operation of colon cancer. Methods 72 cases of patients with carcinoma of colon needing radical surgery in our hospital from June 2015 to June 2017 were selected and randomly divided into two groups with 36 cases in each, the control group were treated with routine radical operation of colon cancer, while the treatment group were treated with laparoscope operation of colon cancer, and the occurrence of early inflammatory intestinal, operation time, postoperative exhaust time, postoperative length of stay, operation effect of colon cancer and VAS pain degree scores at different time points were compared between the two groups. Results There were only 2 cases with early inflammatory intestinal obstruction events, which were lower than that in the control group（ 8 cases）（χ~2=4.38, P 0.05）; and the operation time, exhaust time after surgery and postoperative length of stay were shorter than those in the control group, [（178.34±32.71）min,（32.24±12.72）h,（10.36±2.10）d vs（206.82±42.25）min,（64.39±14.05）h,（16.34±2.58）d],（t=29.613 8,30.261 9,13.342 8,P0.05）, and the total effective rate of surgery was higher than that in the control group,（91.7% vs 69.4%）,（χ~2=4.64,P0.05）, and the improvement ranges of VAS pain degrees at different time points after surgery were bigger than those in the control group, [on the day after surgery（7.31 ±0.49）points, on the third day after surgery（3.01 ±0.55）points, t =11.997 6 vs on the day after surgery（7.54±0.86）points, on the third day after surgery（5.62±0.63）points, t=11.034 2]（P0.05）. Conclusion The laparoscopic surgery in treatment of patients with colon cancer can obviously reduce the occurrence probability of early inflammatory intestinal events, relieve the pains of patients and obviously improve the treatment effect.