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目的探讨不同肠减压策略在左半结肠癌急性肠梗阻患者Ⅰ期根治性切除吻合术中应用价值的差异。方法选取114例左半结肠癌并急性肠梗阻患者为研究对象,将其分成研究组(A组,n=57)和对照组(B组,n=57)两组。两组患者均接受Ⅰ期根治性切除吻合术,其中B组采用近端结肠灌洗减压方案,A组采用免灌洗肠减压方案。比较两组患者平均术程、肛门排气时间、首次进食时间、胃管拔管时间、总住院时间等围术期指标差异,记录其围术期死亡率及术后并发症发生情况。结果 1A组患者平均术程、肛门排气时间、首次进食时间、胃管拔管时间、总住院时间等围术期指标均显著短于B组患者(P<0.05);2两组患者在围术期死亡率对比差异未见统计学意义(P>0.05);A组患者术后并发症发生率为12.3%,显著低于B组(29.8%)(P<0.05)。结论对左半结肠癌急性肠梗阻患者给予免灌洗肠减压Ⅰ期根治性切除吻合术,肠减压效果确切,可有效降低其术后并发症发生率,安全有效,值得临床推广。
Objective To investigate the difference in the value of different intestinal decompression strategies in radical resection and anastomosis of patients with acute intestinal obstruction of left-sided colon cancer. Methods One hundred and fourteen patients with left colon cancer and acute intestinal obstruction were enrolled and divided into two groups: study group (group A, n = 57) and control group (group B, n = 57). Two groups of patients underwent radical resection and anastomosis of stage I, in which group B received proximal colon lavage decompression protocol and group A received irrigation-free intestinal decompression protocol. The difference of perioperative indexes such as average course of operation, anus exhaust time, first time of feeding, extubation time of gastric tube and total length of hospital stay were compared between the two groups. The perioperative mortality and postoperative complications were recorded. Results The average duration of operation, the time of anus exhaust, the time of first feeding, the time of extubation and the total length of hospital stay in group A were significantly shorter than those in group B (P <0.05) There was no significant difference in operative mortality (P> 0.05). The incidence of postoperative complications in group A was 12.3%, which was significantly lower than that in group B (29.8%) (P <0.05). Conclusion In patients with acute intestinal obstruction of left colon cancer, the first-stage radical resection and anastomosis with no-lavage intestinal decompression is performed. The decompression effect of intestine decompression is definite, which can effectively reduce the incidence of postoperative complications and is safe and effective.