急诊Ⅰ期切除吻合术治疗梗阻性左半结肠癌的效果及防范再次手术的价值研究

Study on the effect of emergency stageⅠresection and anastomosis in the treatment of obstructive left colon cancer and the value of preventing reoperation

目的研究急诊Ⅰ期切除吻合术治疗梗阻性左半结肠癌的效果以及对防范再次手术的应用价值。方法45例梗阻性左半结肠癌患者,根据治疗方式不同分为对照组(23例)和观察组(22例)。对照组患者采用分期结肠切除吻合术治疗,观察组患者应用Ⅰ期切除吻合术治疗。比较两组患者临床疗效、再次手术情况及手术指标(肛门排气时间、引流管拔除时间、下床活动时间和住院时间)。结果观察组治疗总有效率90.91%明显高于对照组的65.22%,差异有统计学意义(P<0.05)。观察组肛门排气时间(2.33±0.85)d、引流管拔除时间(4.35±1.51)d、下床活动时间(3.80±1.16)d及住院时间(12.04±2.72)d均短于对照组的(3.28±1.04)、(6.15±1.83)、(5.23±1.25)、(15.64±3.63)d,差异有统计学意义(P<0.05)。观察组再次手术发生率4.55%明显低于对照组的43.48%,差异有统计学意义(P<0.05)。结论通过急诊Ⅰ期切除吻合术对梗阻性左半结肠癌患者进行治疗,能明显提升整体治疗效果,缩短恢复时间,也可有效防范再次手术的发生,值得推荐。

Objective To study the effect of emergency stageⅠresection and anastomosis in the treatment of obstructive left colon cancer and the value of preventing reoperation.Methods A total of 45 patients with obstructive left colon cancer were divided into control group(23 cases)and observation group(22 cases)according to different treatment methods.Patients in the control group were treated with staged colectomy and anastomosis,while patients in the observation group were treated with stageⅠresection and anastomosis.The clinical efficacy,reoperation and surgical indicators(anal exhaust time,drainage tube removal time,off-bed activity time and hospital stay)were compared between the two groups.Results The total effective rate in the observation group was 90.91%,which was significantly higher than 65.22%in the control group,and the difference was statistically activity significant(P<0.05).The anal exhaust time(2.33±0.85)d,drainage tube removal time(4.35±1.51)d,off-bed time(3.80±1.16)d and hospital stay(12.04±2.72)d in the observation group were significantly shorter than(3.28±1.04),(6.15±1.83),(5.23±1.25)and(15.64±3.63)d in the control group,and the differences were statistically significant(P<0.05).The reoperation rate in the observation group was 4.55%,which was significantly lower than 43.48%in the control group,and the difference was statistically significant(P<0.05).Conclusion The treatment of patients with obstructive left colon cancer through emergency stageⅠresection and anastomosis can improve the overall effect of the treatment,shorten the recovery time of the patient,and effectively prevent the occurrence of reoperation.It is worth recommending.