急诊行Ⅰ期根治性切除吻合治疗结直肠癌并发急性梗阻的效果及生存率观察

Survival Rate of Colorectal Cancer Complicated with Acute Obstruction Treated with Radical Resection and Anastomosis of Stage Ⅰ in Emergency Room

目的观察分析急诊收治的结直肠癌并发急性梗阻的患者接受I期根治性切除吻合手术治疗的临床效果和生存率。方法将2015年3月-2018年3月在四川省绵阳市中心医院行急诊外科手术的结直肠癌并发急性梗阻96例患者纳入研究,按照随机数字表法分为对照组和观察组,各48例,观察组研究对象均接受Ⅰ期根治性切除吻合手术,对照组研究对象接受Ⅰ期切除Ⅱ期吻合手术。观察两组研究对象接受手术后的手术效果、血清炎症因子水平、手术并发症情况、术后6个月生存率。结果观察组手术时间和住院时间分别低于对照组(P<0.05)。术前两组患者血清中IL-6、TNF-α比较差异无统计学意义(P>0.05);术后两组血清中IL-6、TNF-α水平均较术前均明显降低(P<0.05),且观察组低于对照组(P<0.05)。观察组术后并发症发生率显著低于对照组(P<0.05)。观察组和对照组的术后6个月生存率比较差异无统计学意义(P>0.05)。术后6个月观察组KPS评分在良好以上者占比高于对照组(P<0.05)。结论急诊行Ⅰ期根治性切除吻合手术可明显缩短手术时间和住院时间,促进炎性因子水平恢复,降低并发症发生率。

Objective To observe and analyze the clinical effect and survival rate of colorectal cancer complicated with acute obstruction treated with radical resection and anastomosis of stageⅠin the emergency room.Methods Ninety-six patients with acute obstruction of colorectal cancer undergoing emergency surgery at Mianyang Central Hospital between March 2015 and March 2018 were included in this study.According to the Stochastic numerical table method,these patients were evenly divided into the control group and the observation group.The observation group was treated with radical resection and anastomosis in stageⅠ,while the control group underwent stageⅠresection and stageⅡanastomosis.The surgical effect,serum inflammatory factor levels,surgical complications and survival rate 6 months after operation were observed in both groups.Results The duration of surgery and hospital stay of the observation group were shorter than those of the control group(P<0.05).There was no significant difference in serum levels of IL-6 or TNF-αbetween the two groups before operation(P>0.05).However,the average serum levels of IL-6 and TNF-αin the two groups after operation were significantly lower(P<0.05),especially in the observation group(P<0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in the survival rate 6 months after operation between the two groups(P>0.05).The proportion of KPS scores in the observation group was higher than that in the control group 6 months after operation(P<0.05).Conclusion Treatment of colorectal cancer complicated with acute obstruction with radical resection and anastomosis of stageⅠin emergency rooms can obviously shorten the duration of surgery and hospital stay,promote the recovery of inflammatory factor levels,and reduce the incidence of complications.