结肠癌患者采用改良右半结肠切除术治疗的临床分析

Clinical Analysis of Patients with Colon Cancer Treated with Modified Right Hemicolectomy

目的探讨结肠癌患者采用改良右半结肠切除术治疗的临床效果。方法方便选取该院(2014年1月—2015年1月)收治的90例结肠癌患者为研究对象,根据治疗方法不同分为两组,观察组45例患者采用改良右半结肠切除术治疗,对照组45例患者采用传统手术治疗,对比两组患者手术指标和并发症发生率以及1、2、3年淋巴结转移复发率和生存率。结果观察组患者手术时间、住院时间分别为(69.85±9.15)min、(12.78±2.13)d,明显短于对照组(85.76±14.21)min、(15.64±2.04)d,术中出血量(124.57±14.30)m L明显少于对照组(159.80±14.16)m L,淋巴结清扫个数(15.70±1.31)个明显多于对照组(13.76±1.26)个,胃肠道恢复时间(3.68±0.93)d,明显快于对照组(4.49±1.01)d,差异有统计学意义(t=6.314 8、6.505 0、11.743 4、7.159 9、3.957 6,P<0.05)。观察组患者并发症发生率6.67%明显低于对照组22.22%,差异有统计学意义(χ2=9.7829,P<0.05)。观察组患者3年淋巴结转移复发率和生存率8.89%、84.44%明显优于对照组24.44%、64.44%,差异有统计学意义(χ2=8.705 6、10.511 5,P<0.05)。结论结肠癌患者采用改良右半结肠切除术治疗的临床疗效显著,可有效改善患者手术指标,降低并发症发生率和转移复发率,提高远期生存率,值得临床推广。

Objective To investigate the clinical effects of patients with colon cancer undergoing right hemicolectomy.Methods A total of 90 patients with colon cancer who were convenient admitted to the hospital （January 2014 to January2015） were selected as the study subjects. The patients were divided into two groups according to different treatment methods. 45 patients in the observation group were treated with modified right colon colectomy. 45 patients were treated with traditional surgery. The surgical index and incidence of complications, and the recurrence rate and survival rate of lymph nodemetastasis at 1 year, 2 years, and 3 years were compared between the two groups. Results The operative time and length ofstay in the observation group were（69.85±9.15）minutes and（12.78±2.13）days, respectively, which were significantly shorterthan those in the control group [（85.76±14.21）minutes,（15.64±2.04）days]. The intraoperative blood loss was （124.57±14.30）mL, which was significantly less than the control group [（159.80±14.16）mL], the number of lymph node dissectionswas （15.70±1.31） significantly more than the control group （13.76±1.26）, and the recovery time of the gastrointestinal tractwas （3.68±0.93）d, which was significantly faster than the control group [（4.49±1.01）d]. The difference was statistically significant （t= 6.314 8, 6.505 0, 11.743 4, 7.159 9, 3.957 6, P〈0.05）. The incidence rate of complications in the observationgroup was 6.67%, which was significantly lower than that in the control group （22.22%）. The difference was statistically significant （X^2=9.782 9, P〈0.05）. The 3-year recurrence rate and survival rate of lymph node metastasis in the observationgroup were 8.89% and 84.44%, which were significantly between than those in the control group（24.44% and 64.44%）. Thedifference was statistically significant （X^2=8.705 6, 10.511 5, P〈0.05）. Conclusion The clinical effect of colon cancer patientswith improved right hemicolectomy is significant, which can effectively improve the surgical index of patients, reduce the incidence of complications and metastasis recurrence rate, improve long-term survival rate, and is worthy of clinical promotion.