中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2010年
1期
42-43
,共2页
结直肠肿瘤%肠梗阻%外科手术
結直腸腫瘤%腸梗阻%外科手術
결직장종류%장경조%외과수술
Colorecud neoplasms%Intestinal obstruction%Surgical procedures
目的 探讨结直肠癌并发急性肠梗阻的治疗原则.方法 选取结直肠癌并发急性肠梗阻患者86例,回顾性分析患者的临床资料和治疗方法.结果 86例患者中,右半结肠癌并梗阻60例,左半结肠和直肠癌并梗阻24例.Duke分期:A期5例,B期12例,C期43例,D期26例.行一期切除吻合70例(右半结肠一期切除吻合54例,左半结直肠一期切除吻合14例),Hartmann手术9例,回肠乙状结肠或回肠直肠吻合捷径手术3例.78例(90.7% )痊愈出院,21例(24.4% )发生手术并发症,以切口感染、腹腔感染和吻合口漏为主.死亡8例(9.3% ).结论 结直肠癌并发急性肠梗阻病情凶险,需要合理选择手术时机和手术方式,手术应及时并遵循个体化原则,创造条件,力争一期手术切除肿瘤,解除梗阻,以提高治愈率,减少并发症.
目的 探討結直腸癌併髮急性腸梗阻的治療原則.方法 選取結直腸癌併髮急性腸梗阻患者86例,迴顧性分析患者的臨床資料和治療方法.結果 86例患者中,右半結腸癌併梗阻60例,左半結腸和直腸癌併梗阻24例.Duke分期:A期5例,B期12例,C期43例,D期26例.行一期切除吻閤70例(右半結腸一期切除吻閤54例,左半結直腸一期切除吻閤14例),Hartmann手術9例,迴腸乙狀結腸或迴腸直腸吻閤捷徑手術3例.78例(90.7% )痊愈齣院,21例(24.4% )髮生手術併髮癥,以切口感染、腹腔感染和吻閤口漏為主.死亡8例(9.3% ).結論 結直腸癌併髮急性腸梗阻病情兇險,需要閤理選擇手術時機和手術方式,手術應及時併遵循箇體化原則,創造條件,力爭一期手術切除腫瘤,解除梗阻,以提高治愈率,減少併髮癥.
목적 탐토결직장암병발급성장경조적치료원칙.방법 선취결직장암병발급성장경조환자86례,회고성분석환자적림상자료화치료방법.결과 86례환자중,우반결장암병경조60례,좌반결장화직장암병경조24례.Duke분기:A기5례,B기12례,C기43례,D기26례.행일기절제문합70례(우반결장일기절제문합54례,좌반결직장일기절제문합14례),Hartmann수술9례,회장을상결장혹회장직장문합첩경수술3례.78례(90.7% )전유출원,21례(24.4% )발생수술병발증,이절구감염、복강감염화문합구루위주.사망8례(9.3% ).결론 결직장암병발급성장경조병정흉험,수요합리선택수술시궤화수술방식,수술응급시병준순개체화원칙,창조조건,력쟁일기수술절제종류,해제경조,이제고치유솔,감소병발증.
Objective To evaluate the methods and efficacy of surgical emergency treatment on colorectal cancer combined with intestinal obstruction.Methods Clinical data of 86 cases with obstructing colorectal cancers underwent emergency operation were analyzed retrospectively.Results There were 60 cases with right hemicolon carcinomns combined obstruction,and 24 cases with left hemicolon and rectal cancels with obstruction.The cases in Duke A,B,Cand D stages are 5,12,43 and 26 respectively.All patients received emergency operation.Stage I tumor resection and anastomosis were performed on 70 patienm including 54 risht and 14 left hemicolon carcinomas.There were 9 cases treated by Hartmann operations,3 bypass operations of ileorectal or ileocolonal anastomosis.78 of 86 cases (90.7% ) were healed well except 8 patients died after operation.Postoperative complications occurred in 21 cases (24.4% ),including incision infection,intraperitoneal infection and intestinal fistula.Condusion Stage I tumor resection and anastomosis combined with coloclysis through appendiceal stump are feasible and safe surgical procedures in the treatment of colorectal cancers complicated by acute ileus.
