CAJ | 학술논문

目的：探讨手术治疗结肠癌并发急性肠梗阻的临床经验，进一步提高临床疗效。方法：2012年1月-2014年1月收治结肠癌并发急性肠梗阻患者80例，采用肿瘤切除+乙状结肠吻合+吻合口近端结肠造瘘13例(16.25%)；单纯结肠造瘘8例(10.0%)；单纯结肠造瘘，Ⅱ期肿瘤切除术11例(13.75%)；术中结肠灌洗+肿瘤根治性切除+乙状结肠/直肠上段端吻合术28例(35.0%)；肿瘤切除+近端结肠造瘘，Ⅱ期消化道重建术20例(20.0%)。结果：所有患者均痊愈出院，其中2例发生吻合口瘘，均是术中结肠灌洗+肿瘤根治性切除+乙状结肠/直肠上段端吻合术式，肿瘤切除+近端结肠造瘘、Ⅱ期消化道重建术式中1例患者出现切口感染。术中结肠灌洗+肿瘤根治性切除+乙状结肠/直肠上段端吻合术式和肿瘤切除术+乙状结肠吻合+吻合口近端结肠造瘘术式、肿瘤切除+近端结肠造瘘术式，单纯结肠造瘘及Ⅱ期肿瘤切除术式、Ⅱ期消化道重建术式症状缓解时间、肛门排气时间、住院时间明显高于单纯结肠造瘘术式。结论：手术治疗结肠癌并发急性肠梗阻是首选的治疗方法，应该根据患者的自身情况选择具体术式。
목적：탐토수술치료결장암병발급성장경조적림상경험，진일보제고림상료효。방법：2012년1월-2014년1월수치결장암병발급성장경조환자80례，채용종류절제+을상결장문합+문합구근단결장조루13례(16.25%)；단순결장조루8례(10.0%)；단순결장조루，Ⅱ기종류절제술11례(13.75%)；술중결장관세+종류근치성절제+을상결장/직장상단단문합술28례(35.0%)；종류절제+근단결장조루，Ⅱ기소화도중건술20례(20.0%)。결과：소유환자균전유출원，기중2례발생문합구루，균시술중결장관세+종류근치성절제+을상결장/직장상단단문합술식，종류절제+근단결장조루、Ⅱ기소화도중건술식중1례환자출현절구감염。술중결장관세+종류근치성절제+을상결장/직장상단단문합술식화종류절제술+을상결장문합+문합구근단결장조루술식、종류절제+근단결장조루술식，단순결장조루급Ⅱ기종류절제술식、Ⅱ기소화도중건술식증상완해시간、항문배기시간、주원시간명현고우단순결장조루술식。결론：수술치료결장암병발급성장경조시수선적치료방법，응해근거환자적자신정황선택구체술식。
Objective:To explore the clinical experience of operation treatment of colon cancer combined with acute intestinal obstruction,to further enhance the clinical curative effect.Methods:80 patients with colon cancer combined with acute intestinal obstruction were selected from January 2012 to January 2014.13 cases(16.25% ) were given tumor resection,sigmoid colon anastomosis joint proximal colon anastomotic fistula.8 cases(10.0%) were given simple colon fistula.11 cases(13.75%) were given pure colostomy and Ⅱ the colon tumor resection.28 cases(35.0% ) were given intraoperative colonic lavage + radical tumor resection and sigmoid colon/rectum end anastomosis.20 cases(20.0% ) were given tumor resection and proximal colostomy,the colon Ⅱ of digestive revascularization.Results:All patients were cured and discharged,including 2 cases of anastomotic fistula were intraoperative colonic lavage+radical tumor resection and sigmoid colon/rectum end anastomosis.1 patient of tumor resection and proximal colostomy,the colon Ⅱ of digestive revascularization had incision infection.In the intraoperative colonic lavage+radical tumor resection and sigmoid colon/rectum end anastomosis,tumor resection,sigmoid colon anastomosis joint proximal colon anastomotic fistula,tumor resection and proximal colostomy,pure colostomy and Ⅱ the colon tumor resection,the colon Ⅱ of digestive revascularization,the symptom remission times,anal exhaust times, hospitalization times were significantly higher than that of simple colon fistula.Conclusion:The operation treatment of colon cancer combined with acute intestinal obstruction is the preferred treatment method.It should be based on the patient's own situation to select the specific operation.