肠道支架置入术治疗急性梗阻性结直肠癌的效果观察

Efficacy of intestinal stent implantation in the treatment of acute obstructivecolorectal cancer

目的探讨肠道支架置入术治疗急性梗阻性结直肠癌的有效性。方法依据治疗方式的不同将90例急性梗阻性结直肠癌患者分为支架置入组(n=48)和常规手术组(n=42),比较两组患者的淋巴结清扫数目、肠道恢复通气时间、住院时间、肿瘤根治性切除率、姑息性切除率、血清C反应蛋白(CRP)水平、血清白蛋白(ALB)水平、狭窄段直径和梗阻缓解率。对所有患者随访3年。比较两组患者的并发症发生情况及生存情况。结果支架置入组患者的淋巴结清扫数目多于常规手术组患者,肠道恢复通气时间、住院时间均短于常规手术组患者,肿瘤根治性切除率高于常规手术组,姑息性切除率低于常规手术组(P﹤0.05)。手术后,支架置入组患者的血清CRP水平低于常规手术组患者,血清ALB水平高于常规手术组患者(P﹤0.05)。手术后,支架置入组患者的狭窄段直径大于常规手术组患者(P﹤0.05)。两组患者的梗阻缓解率均为100%。支架置入组患者的并发症发生率低于常规手术组患者(P﹤0.05)。两组患者的平均生存期和3年生存率比较,差异均无统计学意义(P﹥0.05)。结论相较于常规急诊手术,肠道支架置入术治疗急性梗阻性结直肠癌的疗效显著,解除梗阻及清除淋巴结更加彻底,可缩短术后恢复时间,减少术后并发症的发生。

Objective To investigate the efficacy of intestinal stent implantation in the treatment of acute obstructive colorectal cancer.Method According to different treatment methods,90 patients with acute obstructive colorectal cancer were divided into stent implantation group(n=48)and conventional operation group(n=42).The number of lymph node dissection,time of intestinal recovery ventilation,hospitalization time,rate of radical tumor resection,rate of palliative resection,serum C-reactive protein(CRP)level,serum albumin(ALB)level,stenosis segment diameter and obstruction relief rate were compared between the two groups.Patients were followed up for 3 years.The incidence of complications and 3-year survival were compared between the two groups.Result The number of lymph node dissection in the stent implantation group was higher than that in the conventional operation group,and the time of intestinal recovery ventilation and hospitalization were shorter than those in the conventional operation group.The rate of radical tumor resection was higher than that in the conventional operation group,and the rate of palliative resection was lower than that in the conventional operation group(P<0.05).After operation,the serum CRP level in the stent implantation group was lower than that in the conventional operation group,and the ALB level was higher than that in the conventional operation group(P<0.05).After operation,the diameter of the stenosis segment in the stent implantation group was larger than that in the conventional operation group(P<0.05).The obstruction relief rate of both groups was 100%.The incidence rate of complications in the stent implantation group was lower than that in the conventional operation group(P<0.05).There was no significant difference in average survival time and 3-year survival rate between the two groups(P>0.05).Conclusion Compared with routine emergency surgery,the intestinal stent implantation is effective in the treatment of acute obstructive colorectal cancer,which can relieve obstruction and remove lymph nodes more completely,shorten the postoperative recovery process and reduce the postoperative complications.