肠道支架置入联合择期手术与急诊手术治疗梗阻性结直肠癌的效果比较

Comparison of the effects of intestinal stent placement combined with elective surgery and emergency surgery in the treatment of obstructive colorectal cancer

目的比较肠道支架置入联合择期手术与急诊手术治疗梗阻性结直肠癌的效果。方法选取2020年1月至2023年5月我院收治的62例梗阻性结直肠癌患者作为研究对象,按照随机数字表法将其分为对照组(31例,急诊手术治疗)和研究组(31例,肠道支架置入联合择期手术治疗)。比较两组的手术效果。结果研究组的手术时间、术后首次通气时间及术后住院时间短于对照组,术中出血量少于对照组,淋巴结清扫数量多于对照组,一期吻合率高于对照组,造口率低于对照组(P<0.05)。术后3 d,观察组的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平低于对照组,CD3^(+)、CD4^(+)高于对照组(P<0.05)。术后1、3、6个月,研究组的低位前切除综合征(LARS)评分低于对照组(P<0.05)。结论与急诊手术比较,肠道支架置入联合择期手术治疗梗阻性结直肠癌患者的效果更优,可降低造口率,提高一期吻合率,减轻对肛门功能产生的负面影响,利于加快患者术后恢复进程。

Objective To compare the effects of intestinal stent placement combined with elective surgery and emergency surgery in the treatment of obstructive colorectal cancer.Methods A total of 62 patients with obstructive colorectal cancer admitted in our hospital from January 2020 to May 2023 were selected as the research objects.According to the random number table method,the patients were divided into control group(31 cases,emergency surgery)and study group(31 cases,intestinal stent placement combined with elective surgery).The surgical effects of the two groups were compared.Results The operation time,postoperative first ventilation time and postoperative hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,the number of lymph node dissection was more than that of the control group,the first stageanastomosis rate was higher than that of the control group,and the stoma rate was lower than that of the control group(P<0.05).At 3 d after operation,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the observation group were lower than those in the control group,while the CD3^(+)and CD4^(+)were higher than those in the control group(P<0.05).At 1,3 and 6 months after operation,the Low Anterior Resection Syndrome(LARS)score of the study group was lower than that of the control group(P<0.05).Conclusion Compared with emergency surgery,intestinal stent placement combined with elective surgery is more effective in the treatment of patients with obstructive colorectal cancer.It can reduce the stoma rate,improve the first stageanastomosis rate,reduce the negative impact on anal function,and accelerate the postoperatie recovery process of patients.