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目的观察并比较腹腔镜与开腹手术治疗结肠癌临床效果及安全性。方法选取我院2005年5月至2011年3月收治结肠癌患者90例,采用随机数字表法分为两组,即开腹手术组和腹腔镜手术组,每组各45例,分别采用传统开腹手术和腹腔镜手术治疗;比较两组患者手术时间、术中出血量、淋巴结清除数、术后排气时间、镇痛时间、住院时间、住院费用、1年生存率、术后生活质量评分及并发症发生情况等。结果腹腔镜手术组患者术中出血量明显少于开腹手术组,组间比较差异有统计学意义(P<0.05);同时两组患者手术时间及淋巴结清除数组间比较差异无统计学意义(P>0.05);腹腔镜手术组患者术后排气时间、镇痛时间及住院时间明显短于开腹手术组,且术后生理功能、心理情绪及社会功能等术后生活质量评分明显优于开腹手术组,组间比较差异有统计学意义(P<0.05);同时两组患者住院费用及1年生存率组间比较差异无统计学意义(P>0.05);开腹手术组患者术后发生切口感染5例,吻合口出血4例,肠梗阻1例,并发症发生率为22.2%;腹腔镜手术组患者术后发生切口感染2例,吻合口出血2例,肠梗阻0例,并发症发生率为8.9%;腹腔镜手术组患者术后并发症发生率明显少于开腹手术组(P<0.05)。结论腹腔镜治疗结肠癌较传统开腹手术,可以有效减少术中创伤,促进术后康复,缩短病程,提高术后生活质量,临床效果满意。
Objective To observe and compare the clinical efficacy and safety of laparoscopic and open surgery for colon cancer. Methods Totally 90 patients with colon cancer who were treated in our hospital from May 2005 to March 2011 were randomly divided into two groups: laparotomy group and laparoscopic surgery group, 45 cases in each group, Laparotomy and laparoscopic surgery. The operation time, intraoperative blood loss, lymph node clearance, postoperative exhaust time, analgesia time, hospitalization time, hospitalization cost, 1-year survival rate, postoperative quality of life Score and complications occurred. Results The intraoperative blood loss in laparoscopic surgery group was significantly less than that in open surgery group, the difference was statistically significant (P <0.05); there was no significant difference between the two groups in operation time and lymph node clearance group P> 0.05). The postoperative exhaust time, analgesic time and hospital stay in laparoscopic surgery group were significantly shorter than those in open surgery group, and postoperative quality of life, physiological function, psychological emotion and social function were significantly better than postoperative There were significant differences between the two groups (P <0.05). There was no significant difference between the two groups in hospitalization cost and 1-year survival rate (P> 0.05) After incision infection in 5 cases, anastomotic bleeding in 4 cases, intestinal obstruction in 1 case, the complication rate was 22.2%; laparoscopic surgery group patients after incision infection in 2 cases, anastomotic bleeding in 2 cases, intestinal obstruction in 0 cases, The incidence of complications was 8.9%. The incidence of postoperative complications in laparoscopic surgery group was significantly less than that in open surgery group (P <0.05). Conclusion Laparoscopic treatment of colon cancer than the traditional open surgery, can effectively reduce intraoperative trauma, promote postoperative recovery, shorten the course of disease, improve postoperative quality of life, the clinical effect is satisfactory.