CAJ | 학술논문

目的评价结直肠癌性梗阻急诊手术与在内镜下金属支架置入后择期手术的临床疗效.方法选择30例有手术指征的癌性梗阻患者接受急诊手术,28例癌性梗阻并有手术指征的患者接受支架置入术,作为肠道准备的过渡性治疗,3～5d后行结直肠癌根治术,一期吻合.对比手术并发症发生率、住院费用及住院时间.结果 30例急诊手术患者,27例行结直肠癌根治,近端造瘘、远端封闭术,3个月后行造瘘还纳,1例行根治性切除,近端造瘘、远端封闭后4d因多脏器功能衰竭死亡,2例肿瘤晚期无法切除行近端造瘘术.27例癌性梗阻患者成功置入支架,1例因肠腔闭塞置入失败,支架置入后即出现排便,积极肠道准备,3～5d后行结直肠癌根治术,一期吻合.择期手术组的并发症发生率、住院费用、住院时间明显低于急诊手术组,差异有统计学意义(P＜0.05).结论结直肠癌性梗阻患者在内镜下金属支架置入解除梗阻后择期手术,可降低患者的费用,缩短住院时间,提高生活质量.
목적 평개결직장암성경조급진수술여재내경하금속지가치입후택기수술적림상료효.방법 선택30례유수술지정적암성경조환자접수급진수술,28례암성경조병유수술지정적환자접수지가치입술,작위장도준비적과도성치료,3～5d후행결직장암근치술,일기문합.대비수술병발증발생솔、주원비용급주원시간.결과 30례급진수술환자,27례행결직장암근치,근단조루、원단봉폐술,3개월후행조루환납,1례행근치성절제,근단조루、원단봉폐후4d인다장기공능쇠갈사망,2례종류만기무법절제행근단조루술.27례암성경조환자성공치입지가,1례인장강폐새치입실패,지가치입후즉출현배편,적겁장도준비,3～5d후행결직장암근치술,일기문합.택기수술조적병발증발생솔、주원비용、주원시간명현저우급진수술조,차이유통계학의의(P＜0.05).결론 결직장암성경조환자재내경하금속지가치입해제경조후택기수술,가강저환자적비용,축단주원시간,제고생활질량.
Objective To evaluate the clinical efficacy of emergency operation and elective operation after intestinal metal stents on obstructive colorectal cancer.Methods Thirty surgically indicated patients with colorectal obstruction underwent emergency surgery.Twenty-eight patients underwent metal stent placement as transitional treatment,and underwent radical resection of colorectal cancer after 3-5 days,one-stage operation.Surgical complication rates,hospital costs and length of stay were observed in treated patients.Results About 27 of total 30 patients received emergency operation (proximal colostomy and remote closed),and the stoma was returned after 3 months.One case was dead due to multiple organ failure,4 days after operation,and two late-stage cancer patients received colorectal gastrostomy,because the tumors can not beremoved.Metal stents were performed in 27 of total 28 patients,the procedure failed in one case,because the colon was entirely blocked.Defecation occurred after colon bracket insertion operation under endoscopy,and radical resections of colorectal cancer (one-stage operation)were peformed after bowel preparation for 3-5 days.There were significant differences between the two groups in surgical complication rates,hospital costs and length of stay (P ＜ 0.05).Conclusions Colorectal cancer obstruction patients underwent radical resection of colorectal cancer,one-stage operation,after relief of obstruction by metal stents,which can shorten hospital stay,reduce the cost of hospitalization,and improve the quality of life.