结直肠癌性梗阻48例临床诊治体会
Clinical Experiences in Diagnosis and Treatment of Intestinal Obstruction of 48 Patients with Colorectal Cancer
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摘要: [摘要]目的 探讨结直肠癌性肠梗阻的临床特点和诊治方法. 方法 对2002年9月至2010年9月间收治的48例结直肠癌性肠梗阻患者的临床资料进行回顾性分析. 结果 48例结直肠癌性肠梗阻均行手术治疗.术前表现为不全性梗阻25例,一期切除后吻合 22例(右半结肠癌梗阻8例,左半结直肠癌梗阻14例),短路手术1例,姑息造口2例;术前表现为完全性梗阻23例,一期切除后吻合5例(均为右半结肠癌梗阻),一期切除后近端造口12例(半年后造口回纳6例),姑息造口6例,术后出现吻合口漏2例,1例经通畅引流、肠外营养支持痊愈,1例放弃治疗,自动出院后5 d死亡;肺部感染6例;切口感染8例. 结论 根据治疗癌性梗阻患者的具体情况,选择合理的手术时机和手术方式,是提高治疗癌性梗阻疗效的关键Abstract: [Abstract]Objective To investigate the clinical features and the diagnosis and treatment of colorectal cancer and intestinal obstruction.Method The clinical data of 48 patients(2002.9-2010.9) with colorectal cancer and intestinal obstruction were retrospectively analyzed.Results All of the 48 cases of colorectal cancer and intestinal obstruction underwent surgery.25 cases were incomplete preoperative obstruction before surgery,includingⅠresection anastomosis in 22 cases(right colon cancer obstruction in 8 cases,left colorectal cancer obstruction in 14 cases), short-circuit operation in 1 case,palliative colostomy in 2 cases;23 cases were complete preoperative obstruction before surgery,includingⅠresection anastomosis in 5 cases(both right colon cancer obstruction),a proximal stoma afterⅠresection in 12 patients(six months after stoma back satisfied in 6 cases),palliative stoma in 6 cases.Postoperative anastomotic leakage occurred in 2 cases,1 case recovered after unobstructed drainage and parenteral nutrition suppor,1 gave up treatment,and died at five days after left the hospital;pulmonary infection was fund in 6 cases;wound infection in was 8 cases.Conclusion Strengthening the understanding of colorectal cancer and intestinal obstruction, and choosing the timing of surgery and the surgical approach according to patients with specific conditions are the keys to improve the efficacy.
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