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目的评价碘伏灌洗联合外喷生物胶Ⅰ期手术治疗肠癌并完全性肠梗阻的疗效。方法共49例结直肠癌合并完全性肠梗阻患者,随机分为研究组19例和对照组30例。研究组患者行肿瘤根治术后,以碘伏灌洗肠腔,并于吻合口外喷医用生物胶。对照组16例Ⅰ期梗阻近侧结肠造瘘减压后,Ⅱ期行肿瘤根治肠吻合术;14例Ⅰ期行肿瘤根治术断端造瘘后,Ⅱ期行肠吻合术。结果研究组未发生吻合口漏等严重并发症,术后3、5年生存率分别为84%和58%,疗效明显优于对照组(P<0.05)。对照组中5例因瘘口粪便污染出现切口感染,3、5年生存率为57%和27%。结论碘伏灌洗联合外喷生物胶Ⅰ期手术的治疗方案可有效提高手术疗效,预防术后并发症,患者预后较分期手术有明显改善。
Objective To evaluate the efficacy of iodophor lavage combined with external injection of biological glue for the treatment of colorectal cancer and complete intestinal obstruction. Methods A total of 49 patients with colorectal cancer and complete intestinal obstruction were randomly divided into study group (n=19) and control group (n=30). The patients in the study group underwent tumor resection and were treated with iodophor lavage in the intestine, and medical bio glue was applied outside the anastomosis. In the control group, 16 patients with stage I obstruction underwent colostomy decompression, and stage II tumors underwent radical anastomosis; 14 patients underwent stage I radical nephrectomy and stage II enteral anastomosis. Results No severe complications such as anastomotic leakage occurred in the study group. The 3-year and 5-year survival rates were 84% and 58%, respectively. The curative effect was significantly better than that of the control group (P<0.05). Five patients in the control group had wound infection due to mouthwash contamination, and the 3 and 5-year survival rates were 57% and 27%. Conclusion The treatment plan of iodophor lavage combined with external injection of biological glue can effectively improve the curative effect, prevent postoperative complications, and improve the prognosis of patients with staging.