摘要
目的:探讨肠管部分切除术在卵巢癌根治术中的临床应用效果,同时观察和总结肠管部分切除术后感染发生情况,以降低感染发生率。方法:选择2007年7月—2013年11月在河南科技大学第一附属医院接受卵巢癌根治术的49例卵巢癌肠道转移患者作为研究对象,对其临床资料进行回顾性分析,所有患者均行卵巢癌根治术和肠道手术,其中21例肠道手术方式为肠段部分切除术,28例为肿瘤剥除术。观察所有患者的治疗效果及术后感染、肠瘘、肠梗阻等并发症情况。结果:肠管部分切除组患者术后5例(23.81%)发生切口感染,肿瘤剥除术组2例(7.14%)发生切口感染,前者术后感染的发生因素主要与手术切口部位、切口类型、患者机体免疫机能、病原菌耐药性等有关;对两组患者随访2年以上,肠管部分切除术组患者1年、3年和5年的生存率分别为90.48%、66.67%和57.14%,均高于肿瘤剥除术组的82.14%、42.86%和21.43%,其中两组患者5年生存率比较,差异有统计学意义(χ^(2)=0.681、2.731、9.016,P<0.05);肠管部分切除术组随访2年以上和5年以上的缓解率分别为66.67%和28.57%,明显高于肿瘤剥除术组的7.14%和0.00%,差异有统计学意义(χ^(2)=19.334、9.016,P<0.05)。结论:晚期卵巢癌常出现肠道转移,因此在行卵巢癌根治术时应将受累的肠管切除,有助于改善患者的预后。但肠管部分切除术后容易发生盆腔感染、肠瘘、肠梗阻等情况,可通过术前完善的肠道清洁准备,术中做好切口区域的保护,术后加强患者营养及预防性应用抗生素等方式降低感染等发生率,提高手术效果。
Objective: To investigate the clinical effect of partial resection of intestinal canal in radical resection of ovarian cancer, and to observe and summarize the incidence of infection after partial resection of intestinal canal, in order to reduce the incidence of infection. Methods: 49 cases with ovarian cancer intestinal metastasis underwent radical resection of ovarian cancer in the hospital from November 2013 to July 2007 were selected as subjects. Based on retrospective analysis of its clinical data, all patients underwent radical ovarian cancer surgery and bowel surgery. Among them, 21 cases of bowel surgery were partial bowel resection and 28 cases were tumor resection. The treatment effect and complications of postoperative infection, intestinal fistula, and intestinal obstruction were observed in all patients. Results: 5 cases(23.81%) of the patients in the partial resection group were infected with incision, and 2 cases(7.14%) of the tumor removal group were infected by incision, the factors of postoperative infection were mainly related to the location of the incision, the type of incision, the immune function of the patient and the drug resistance of the pathogenic bacteria. Two groups of patients were followed up for more than 2 years, the 1-year, 3-year, and 5-year survival rates of patients in the partial bowel resection group were 90.48%, 66.67%, and 57.14%, respectively, which were higher than 82.14%, 42.86%, and 21.43% in the tumor resection group. There were statistically significant differences in the 5-year survival rate between the two groups(χ^(2)=0.681, 2.731, 6.586, P<0.05). The remission rates of the partial bowel resection group for more than 2 years and more than 5 years were 66.67% and 28.57%, respectively, which were also significantly higher than the7.14% and 0.00% of the tumor resection group(χ^(2)=19.334, 9.016, P<0.05). Conclusion: Intestinal metastasis is often seen in advanced ovarian cancer, therefore, in the treatment of ovarian cancer, it is necessary to remove the affected part of the intestine in time and help to improve the prognosis of the patients. In addition, intestinal infection is easy to happen after partial resection of intestinal tract. Preoperative intestinal tract cleaning preparation, skin preparation, patient nutrition and preventive application of antibiotics can reduce the incidence of infection and improve the surgical effect.
作者
牛亚丹
NIU Ya-dan(Department of Gynecology,First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan,471000,China)
出处
《黑龙江医学》
2022年第18期2208-2210,共3页
Heilongjiang Medical Journal
关键词
卵巢癌
肿瘤转移
肠
吻合术
伤口感染
Ovarian cancer
Tumor metastasis
Intestinal
Anastomosis
Wound infection
