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目的探讨高龄大肠癌并发急性肠梗阻患者采用Ⅰ期切除吻合术治疗的临床效果。方法选取104例高龄大肠癌并发急性肠梗阻患者,按随机数字表法分为对照组和观察组,每组52例。对照组行常规Miles手术治疗,观察组采用Ⅰ期切除吻合术治疗,比较2组患者的并发症发生率和术后6个月及1年的生存率。结果对照组共发生伤口感染9例,尿路感染5例,腹腔感染4例,吻合口瘘3例,伤口裂开2例,并发症发生率为44.23%;观察组发生伤口感染3例,尿路感染、腹腔感染、吻合口瘘和伤口裂开各1例,并发症发生率为13.46%。对照组并发症发生率明显高于观察组(P<0.01)。观察组术后6个月和1年生存率均高于对照组(95.74%比76.74%,P<0.01;72.34%比46.51%,P<0.05)。结论高龄大肠癌并发急性肠梗阻患者采用Ⅰ期切除吻合术治疗疗效显著,安全性较高。
Objective To investigate the clinical effect of stage Ⅰ resection and anastomosis in patients with advanced colorectal cancer complicated with acute intestinal obstruction. Methods 104 cases of elderly patients with colorectal cancer complicated with acute intestinal obstruction were divided into control group and observation group according to random number table method, with 52 cases in each group. The control group received conventional Miles operation. The observation group was treated with stage Ⅰ resection and anastomosis. The complication rates and the 6-month and 1-year survival rates were compared between the two groups. Results There were 9 cases of wound infection, 5 cases of urinary tract infection, 4 cases of abdominal infection, 3 cases of anastomotic fistula and 2 cases of wound rupture. The morbidity rate was 44.23% in the control group, 3 cases of wound infection in the observation group, Road infection, abdominal infection, anastomotic fistula and wound rupture in 1 case, the complication rate was 13.46%. The incidence of complications in the control group was significantly higher than that in the observation group (P <0.01). The 6-month and 1-year survival rates in the observation group were significantly higher than those in the control group (95.74% vs 76.74%, P <0.01; 72.34% vs. 46.51%, P <0.05). Conclusions The treatment of advanced colorectal cancer complicated with acute intestinal obstruction by Ⅰ-stage resection and anastomosis is significant and safe.