CAJ | 학술논문

目的探讨结肠金属支架置入桥接一期手术切除的安全性及卫生经济学价值.方法 2008年至2013年间急诊结肠癌性肠梗阻患者病历资料,根据治疗策略不同,分为结肠支架桥接一期切除组(支架组)和急诊一期切除组(对照组),观察两组患者在手术相关并发症发生率和死亡率、造瘘率和造瘘还纳率、ICU观察率、平均住院日和住院费用以及支架治疗临床成功率及相关并发症发生率的差异.结果支架组和对照组分别有10例、11例患者纳入研究.支架组手术相关并发症发生率、造瘘率均为0,对照组分别为18.2％和100.0％;支架组的平均住院日和住院费用分别为23 d、67 742元,对照组分别为49 d和92 553元;两组患者的手术相关死亡率均为0,ICU观察率分别为20％、18％.结论支架桥接一期切除临床成功率高,且与传统急诊一期切除相比,具有较低的并发症发生率、造瘘率,较少的住院日和住院费用,显示出较高的安全性和卫生经济学价值.
목적 탐토결장금속지가치입교접일기수술절제적안전성급위생경제학개치.방법 2008년지2013년간급진결장암성장경조환자병력자료,근거치료책략불동,분위결장지가교접일기절제조(지가조)화급진일기절제조(대조조),관찰량조환자재수술상관병발증발생솔화사망솔、조루솔화조루환납솔、ICU관찰솔、평균주원일화주원비용이급지가치료림상성공솔급상관병발증발생솔적차이.결과 지가조화대조조분별유10례、11례환자납입연구.지가조수술상관병발증발생솔、조루솔균위0,대조조분별위18.2％화100.0％;지가조적평균주원일화주원비용분별위23 d、67 742원,대조조분별위49 d화92 553원;량조환자적수술상관사망솔균위0,ICU관찰솔분별위20％、18％.결론 지가교접일기절제림상성공솔고,차여전통급진일기절제상비,구유교저적병발증발생솔、조루솔,교소적주원일화주원비용,현시출교고적안전성화위생경제학개치.
Objective To compare the medical economics and safety of colonic metallic stent implantation as a bridge to elective resection with traditional emergency resection.Methods Data of colonic cancer obstruction cases in emergency room from 2008 to 2013 were retrospectively analyzed and divided into stent group(colonic stent as a bridge to surgery) and control group(emergency surgery).Main parameters between the two groups were compared,including surgery-associated mortality and morbidity,colostomy rate and re-anastomosis rate,ICU admitted rate,average days and costs in hospital,and colonic stent insertion associated clinical success rate and mortality.Results Ten and 11 patients were included in stent group and control group respectively.Surgery associated morbidity and colostomy rates were both 0 in stent group,and 18.2％ and 100.0％ in control group.Days of hospitalization and costs were 23 days and 67 742 Yuan in stent group,and 49 days and 92 553 Yuan in control group.The surgery associated mortality rates both were 0 in the two groups.ICU admitted rates were 20％ and 18％ respectively.Conclusion Colonic stenting as a bridge to surgery has a high clinical success rate and has a lower morbidity and colostomy rate,shorter hospitalization days,less cost compared with traditional emergency surgery.This strategy for colonic cancer obstruction is of safety and great health economic value.