结肠癌导致急性肠梗阻行一期手术切除治疗的有效性和安全性分析

Analysis of efficacy and safety of one-stage surgical resection in treatment of acute intestinal obstruction caused by colon cancer

目的:探讨结肠癌导致急性肠梗阻行一期手术切除治疗的有效性和安全性。方法:选取70例结肠癌导致急性肠梗阻患者为研究对象,采用随机数字表法分为对照组和观察组各35例,对照组施行分期手术切除治疗,观察组施行一期手术切除治疗,比较两组手术情况、术后疼痛评分、术后吻合口瘘发生率及术后恢复时间。结果:两组手术时间及淋巴结清扫数量比较,差异均无统计学意义(P>0.05);观察组术中出血量少于对照组,差异有统计学意义(P<0.05);观察组疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组术后吻合口瘘发生率为5.71%,与对照组的2.86%比较,差异无统计学意义(P>0.05);观察组术后肛门排气恢复时间、离床活动时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。结论:一期手术用于结肠癌导致急性肠梗阻患者中,可达到与分期手术相当的肠梗阻治疗效果、淋巴结清扫效果,还具有减少术中出血量、减轻术后疼痛感、加快术后恢复等优势,不会增加吻合口瘘发生。

Objective:To study efficacy and safety of one-stage surgical resection in treatment of acute intestinal obstruction caused by colon cancer.Methods:70 patients with acute intestinal obstruction caused by colon cancer were selected as the research objects,and were divided into control group(n=35)and observation group(n=35)according to the random number table method.The control group received staging surgical resection,while the observation group received one-stage surgical resection.Then,the surgical status,postoperative pain score,incidence of postoperative anastomotic fistula and postoperative recovery time were compared between the two groups.Results:There were no significant differences in the operation time and lymph node dissection number between the two groups(P>0.05).The intraoperative blood loss in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).The pain score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative anastomotic fistula in the observation group was 5.71%,compared with 2.86%in the control group,the difference was not statistically significant(P>0.05).Further,the postoperative anal exhaust recovery time,out-of-bed activity time and hospital stay in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Compared with the staging surgical resection,the one-stage surgical resection has the similar effects and lymph node dissection number,but less intraoperative blood loss and postoperative pain as well as early postoperative recovery without increasing the occurrence of anastomotic fistula.