CAJ | 학술논문

目的：探讨结直肠癌根治术后良性肠梗阻的病因、临床表现、治疗方法以及防治措施。方法收集2007年5月—2013年8月接受结直肠癌根治术治疗的360例患者临床资料，其中24例发生良性肠梗阻，分析良性肠梗阻的发病原因、临床表现（包括生活质量）、治疗方法及防治措施。结果良性肠梗阻占接受结直肠癌根治术治疗患者的6．7％（24／360）。其中机械性肠梗阻83．3％（20／24），动力性肠梗阻16．7％（4／24）。机械性肠梗阻病因包括：肠粘连35％（7／20），急性胃肠炎45％（9／20），放疗10％（2／20），造瘘口挛缩5％（1／20），疝5％（1／20）；动力性肠梗阻病因包括：化疗75％（3／4），手术25％（1／4）。良性肠梗阻的发生与性别无关（chi2＝0．1169， pr＝1．732）。良性肠梗阻在结肠癌与直肠癌患者之间无明显差异（chi2＝0．3280， pr＝0．567）。良性肠梗阻临床表现有腹痛、呕吐、腹胀、停止排气排便，患者均有中度以上疼痛，生活质量卡氏评分均不超过60分。本组7例患者接受手术治疗，17例患者接受保守治疗，所有患者治疗后肠梗阻均解除。结论良性肠梗阻为结直肠癌根治术后影响患者生活质量的因素之一，临床医生应及早进行诊断，及时治疗。
목적：탐토결직장암근치술후량성장경조적병인、림상표현、치료방법이급방치조시。방법수집2007년5월—2013년8월접수결직장암근치술치료적360례환자림상자료，기중24례발생량성장경조，분석량성장경조적발병원인、림상표현（포괄생활질량）、치료방법급방치조시。결과량성장경조점접수결직장암근치술치료환자적6．7％（24／360）。기중궤계성장경조83．3％（20／24），동력성장경조16．7％（4／24）。궤계성장경조병인포괄：장점련35％（7／20），급성위장염45％（9／20），방료10％（2／20），조루구련축5％（1／20），산5％（1／20）；동력성장경조병인포괄：화료75％（3／4），수술25％（1／4）。량성장경조적발생여성별무관（chi2＝0．1169， pr＝1．732）。량성장경조재결장암여직장암환자지간무명현차이（chi2＝0．3280， pr＝0．567）。량성장경조림상표현유복통、구토、복창、정지배기배편，환자균유중도이상동통，생활질량잡씨평분균불초과60분。본조7례환자접수수술치료，17례환자접수보수치료，소유환자치료후장경조균해제。결론량성장경조위결직장암근치술후영향환자생활질량적인소지일，림상의생응급조진행진단，급시치료。
Objective To investigate the effect of quality of life in patients with colorectal cancer by benign intestinal ob-struction after radical resection, and to discuss the causes, the clinical manifestation, the treatment, and the preventing measures.Methods We retrospective analysised 360 cases underwent radical resection of colorectal cancer from May 2007 to August 2013,of 24 patients had benign intestinal obstruction, and we discussed the causes,the clinical manifestation ( quality of life was included) ,the treatment, and the preventing methods.Results The occurrence of Benign intestinal ob-struction was 6.7%(24/360).Of the intestinal Mechanical obstruction was 83.3% (20/24), Of the dynamic ileus was 16.7%(4/24).The cause of mechanical intestinal obstruction included that intestinal adhesion was 35%(7/20), acute gastroenteritis was 45%(9/20), radiotherapy was 10% (2/20), narrow fistula was 5% (1/20), and hernia was 5%(1/20);The cause of dynamic ileus included that chemotherapy was 75%(3/4), and surgery was 25%(1/4).Gender was not associated with benign intestinal obstruction after radical resection(chi2 =0.1169,pr=1.732).There was no sig-nificant difference between patients with colon cancer and patients with rectal cancer( chi2 =0.3280,pr=0.567) .Clinical manifestations included abdominal pain, vomiting, abdominal distension, stopping passing flaut,and stopping defecation. All patients had moderate or severe pain,and the quality of life of Karnofsky score was less than 60 points.7 patients under-went surgery,and 17 patients received conservative treatment.Conclusion Benign intestinal obstruction is one of the factors that affect the quality of life of patients with colorectal cancer after radical resection.Clinicians should be early give patients diagnosis, and give patients timely treatment.