中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2013年
15期
162-163,174
,共3页
关庆斌%罗海军%谭彬斯%刑专
關慶斌%囉海軍%譚彬斯%刑專
관경빈%라해군%담빈사%형전
左半结肠癌%急性肠梗阻%Ⅱ期切除术
左半結腸癌%急性腸梗阻%Ⅱ期切除術
좌반결장암%급성장경조%Ⅱ기절제술
Left colon%Acute intestinal obstruction%PhaseⅡresection
目的探讨左半结肠癌致急性肠梗阻的外科手术方法。方法将2008年1月～2013年1月期间在我院普外科住院治疗的65例左半结肠癌致急性肠梗阻的患者，行Ⅰ期肠切除吻合术47例，经腹结肠癌切除、近端造口、远端封闭术（Hartmann手术）13例，先行结肠造口Ⅱ期手术5例。结果术后并发症发生14例占21.54%（14/65），住院10～18 d，近期治愈65例占100%（65/65）。随访1年65例患者，生存者62例占95.38%（62/65），随访3年者62例，生存者51例占82.25%（51/62），随访5年者51例，生存者21例占41.18%（21/51）。结论科学合理总结分析左半结肠癌致急性肠梗阻患者的疾病情况，应选择合理的术式，尽量让患者行Ⅰ期切除吻合术，可避免Ⅱ期手术给患者带来的痛苦和经济负担，并加强围手术期管理对降低并发症、提高疗效至关重要。
目的探討左半結腸癌緻急性腸梗阻的外科手術方法。方法將2008年1月～2013年1月期間在我院普外科住院治療的65例左半結腸癌緻急性腸梗阻的患者，行Ⅰ期腸切除吻閤術47例，經腹結腸癌切除、近耑造口、遠耑封閉術（Hartmann手術）13例，先行結腸造口Ⅱ期手術5例。結果術後併髮癥髮生14例佔21.54%（14/65），住院10～18 d，近期治愈65例佔100%（65/65）。隨訪1年65例患者，生存者62例佔95.38%（62/65），隨訪3年者62例，生存者51例佔82.25%（51/62），隨訪5年者51例，生存者21例佔41.18%（21/51）。結論科學閤理總結分析左半結腸癌緻急性腸梗阻患者的疾病情況，應選擇閤理的術式，儘量讓患者行Ⅰ期切除吻閤術，可避免Ⅱ期手術給患者帶來的痛苦和經濟負擔，併加彊圍手術期管理對降低併髮癥、提高療效至關重要。
목적탐토좌반결장암치급성장경조적외과수술방법。방법장2008년1월～2013년1월기간재아원보외과주원치료적65례좌반결장암치급성장경조적환자，행Ⅰ기장절제문합술47례，경복결장암절제、근단조구、원단봉폐술（Hartmann수술）13례，선행결장조구Ⅱ기수술5례。결과술후병발증발생14례점21.54%（14/65），주원10～18 d，근기치유65례점100%（65/65）。수방1년65례환자，생존자62례점95.38%（62/65），수방3년자62례，생존자51례점82.25%（51/62），수방5년자51례，생존자21례점41.18%（21/51）。결론과학합리총결분석좌반결장암치급성장경조환자적질병정황，응선택합리적술식，진량양환자행Ⅰ기절제문합술，가피면Ⅱ기수술급환자대래적통고화경제부담，병가강위수술기관리대강저병발증、제고료효지관중요。
Objective To investigate the surgical methods of left colonic carcinoma induced acute intestinal obstruction. Methods Sixty-five patients with left colonic carcinoma induced acute intestinal obstruction hospitalized in the general surgery department of our hospital from January 2008 to January 2013 were selected, of which 47 patients received phase I intestinal resection and anastomosis, 13 patients received transabdominal colon resection, proximal stoma and distal closure surgery (Hartmann surgery), and 5 patients received phase Ⅱ colostomy. Results Postoperative complications occurred in 14 patients, accounting for 21.54% (14/65). After 10 to 18 days of hospitalization, 65 patients were cured, accounting for 100% (65/65). One-year follow-up included 65 patients, of which 62 patients survived, accounting for 95.38% (62/65). Three-year follow-up included 62 patients, of which 51 patients survived, accounting for 82.25% (51/62). Five-year follow-up included 51 patients, of which 21 patients survived, accounting for 41.18% (21/51). Conclusion Rational surgical methods should be selected after analyzing the patients' disease conditions scientifically and rationally. Phase Ⅰ resection and anastomosis should be the primary choice in order to avoid the pain and economic burden brought by phase Ⅱsurgery. Enhancing perioperative management is the key to reduce complications and improve efficacy.
