摘要
目的探讨经肠道支架植入术减压和经肛门肠梗阻导管减压对梗阻性结直肠癌患者的临床疗效。方法选取2020年1月至2023年12月清华大学附属垂杨柳医院梗阻性结直肠癌患者100例,随机分为观察组(n=50)和对照组(n=50),观察组采用经肠道支架植入术减压,对照组采用经肛门肠梗阻导管减压。所有患者的梗阻缓解后,实施腹腔镜下结直肠癌肠管Ⅰ期切除吻合术。比较两组肠道准备时间、手术时间、出血量等术中指标,术后排气时间、术后首次下床活动时间、腹痛腹胀缓解时间等术后指标和术前术后肠管内径及术后并发症。结果100例患者中,男49例、女51例;年龄41~78岁,平均(60.6±6.9)岁。两组一般资料的比较,差异无统计学意义(P>0.05)。与对照组相比,观察组的肠道准备时间较短[(4.3±1.3)d比(5.5±1.5)d]、出血量较少[(38.3±9.7)ml比(43.5±9.4)ml]和手术时间较短[(96.2±27.9)min比(113.7±36.7)min];腹痛腹胀时间较短[(23.3±5.7)h比(32.6±5.0)h]、术后排气时间较早[(67.6±15.4)h比(75.3±20.2)h]和术后首次下床活动时间较早[(31.4±8.6)h比(37.8±10.9)h],差异均有统计学意义(P<0.05)。与对照组相比,观察组的术后肠管内径较小[(2.2±0.6)cm比(2.6±0.8)cm],术后并发症发生率较少[8(16.0%)]比18(36.0%)],差异均有统计学意义(P<0.05)。结论与经肛门肠梗阻导管减压手术相比,经肠道支架植入术减压可减少梗阻性结直肠癌患者的肠道准备时间、出血量、手术时间、腹痛腹胀时间、术后排气时间及术后首次下床活动时间,降低术后肠管内径,并发症更少。
Objective To explore the clinical efficacy of decompression by intestinal stent implantation and decompression by anal ileus catheter in patients with obstructive colorectal cancer.Methods A total of 100 patients with obstructive colorectal cancer in Chuiyangliu Hospital affiliated to Tsinghua University from January 2020 to December 2023 were selected and were randomly divided into observation group(n=50)and control group(n=50).The observation group was treated with intestinal stent implantation decompression,while the control group was treated with anal intestinal obstruction catheter decompression.After the obstruction of all patients was relieved,laparoscopic primary resection and anastomosis of colorectal cancer intestine were performed.Intraoperative indicators such as intestinal preparation time,operation time,blood loss,postoperative indicators such as postoperative exhaust time,first postoperative ambulation time,relief time of abdominal pain and distension,and postoperative intestinal diameter and complications were compared between the two groups.Results Among the 100 patients,there were 49 males and 51 females,aged from 41 to 78 year,with an average age of(60.6±6.9)years.There were no significant differences in general data between the two groups(P>0.05).Compared with the control group,the intestinal preparation time was shorter[(4.3±1.3)d vs.(5.5±1.5)d],the blood loss was less[(38.3±9.7)ml us.(43.5±9.4)mll,the operation time was lower[(96.2±27.9)min us.(113.7±36.7)minl,relief time of abdominal pain and distension was shorter[(23.3±5.7)h us.(32.6±5.0)hl,postoperative exhaust time was earlier[(67.6±15.4)h us.(75.3±20.2)h]and postoperative ambulation time was earlier[(31.4±8.6)h us.(37.8±10.9)h]in the observation group,the differences were statistically significant(P<0.05).Compared with the control group,the postoperative intestinal diameter was smaller[(2.2±0.6)cm vs.(2.6±0.8)cml,and the incidence of postoperative complications was less[8(16.0%)]vs.18(36.0%)]in the observation group,with statistical significance(P<0.05).Conclusions For the treatment of obstructive colorectal cancer,compared with decompression by anal ileus catheter,decompression by intestinal stent implantation can reduce intestinal preparation time,blood loss,operation time,relief time of abdominal pain and distension,postoperative exhaust time and first postoperative ambulation time,reduce postoperative intestinal tube diameter,and has fewer complications.
作者
刘博
辛培
安宏超
李华志
Liu Bo;Xin Pei;An Hongchao;Li Huazhi(Department of General Surgery,Chuiyangliu Hospital Affiliated to Tsinghua University,Beijing 100021,China)
出处
《北京医学》
2025年第5期411-416,共6页
Beijing Medical Journal
关键词
梗阻性结直肠癌
肠道准备时间
排气时间
obstructive colorectal cancer
intestinal preparation time
exhaust time
