摘要
目的研究经肛肠梗阻导管在左半结肠癌合并完全性肠梗阻术前的应用。方法 2012年1月至2014年6月间诊断为左半结肠癌伴急性肠梗阻(梗阻时间不超过24 h)患者65例,最终符合纳入标准观察的患者58例。58例患者随机分组,治疗组32例(术前行经肛肠梗阻导管冲洗减压1周后行腹腔镜下结肠癌根治术),对照组26例(于急诊下行手术治疗)。数据采用Spss16.0统计软件分析,患者Ⅰ期吻合率,吻合口漏的发生率采用χ2检验;平均住院时间及住院费用等指标,以x珋±s表示,t检验。P<0.01有统计学意义。结果腹腔镜手术成功率:治疗组为100%(32/32),对照组为3.84%(1/26),χ2=50.08。治疗组与对照组比:Ⅰ期吻合率:100%(32/32)比19.23%(5/26),χ2=40.05;吻合口漏发生率:3.12%(1/32)比40.00%(2/5),χ2=7.89;术后平均住院时间:(9.2±1.2)d比(14.3±1.3)d,t=7.0;平均住院费:(68 150.00±1 112.34)元比(36 186.00±1 671.24)元,t=8.8。以上各项比较差异均有统计学意义,P<0.01。除了治疗费用治疗组因肠梗阻导管及腹腔镜手术费用高于对照组。其他各个方面均明显优于对照组。结论经肛肠梗阻导管在左半结肠癌肿瘤性肠梗阻患者腹腔镜手术前的应用中有显著的优势,为患者减轻痛苦,应得到大力推广。
Objective To investigate the preoperative application of trans-anus depression catheter in treating bowel obstruction of patients with left hemicolon cancer. Methods From January 2012 and June 2014, 58 of 65 patients with left hemicolon cancer and acute bowel obstruction （obstruction time less than 24 hours） randomly divided into two groups： 32 patients in a treatment group, which used trans-anus depression catheter （ 1 week ） before laparoscopic colorectal cancer surgery, and 26 patients in a control group （emergency surgery ）. Clinical data of the 58 patients were analyzed using SPSS 16.0 statistical software. The incidences of primary anastomosis and anastomotic leakage were compared by the chi-square test ; hospital stay and medical cost （ mean ＋ SD ） were compared by Student ＇s t test （ P 〈 0. 01 ）. Results Laparoscopic surgery was successful in the treatment group, but in only one patient （3.84%） of the control group （χ2 = 50.08 ）. The incidences of primary anastomosis in the treatment group and control group were 100% and 19.23% respectively（ χ2 = 40.05 ）. The Incidences of anastomotic leakage in the treatment group and control group were 3.12% and 40.00% respectively（ χ2 = 7.89）. The durations of hospital stay in the treatment group and control group were （ 9.2 ± 1.2） and （ 14.3 ±1.3 ） days, respectively （ t = 7.0）. Medical costs in the treatment group and control group were （68 150. 00 ±1 112.34） RMB yuan and （36 186.00 ± 1 671.24） RMB yuan respectively （t = 8.8, P 〈 0.01 ）. Medical cost in the treatment group was higher than that in the control group. Other aspects of the treatment group were significantly better than those of the control group. Conclusion The preoperative application of trans-anus depression catheter is advantageous in treating bowel obstruction of patients with left hemicolon cancer.
出处
《中华普外科手术学杂志（电子版）》
2015年第2期39-41,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
结肠肿瘤
肠梗阻
腹腔镜检查
导管插入术
Colonic neoplasms
Intestinal obstruction
Laparoscopy
Catheterization
