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目的探讨结肠癌合并肠梗阻老年患者不同时间内根据患者自身状况采用相应手术治疗的疗效。方法选取2012年10月至2015年10月间海南省昌江黎族自治县人民医院收治的68例患者,其中急诊手术患者26例,择期手术患者42例,行Ⅰ期肿瘤切除肠吻合术患者24例,行Ⅱ期肿瘤切除肠吻合术患者23例,行肠造瘘术患者21例。对比分析患者术后情况,和不同时间、不同手术方式并发症发生情况。结果 68例患者中,经手术治疗好转65例(95.6%),死亡3例(4.4%)。急诊手术后并发症发生率(30.8%)显著高于择期手术的并发症发生率4.8%),差异有统计学意义(P<0.05)。行Ⅰ期肿瘤切除肠吻合术的并发症发生率(33.3%)明显高于行Ⅱ期肿瘤切除肠吻合术(4.3%)和肠造瘘术(4.8%),组间差异有统计学意义(P<0.05)。结论针对结肠癌合并肠梗阻老年患者应根据患者的具体情况确定合理的手术时间及方式,做好并发症预防工作,提高治疗效果。
Objective To investigate the curative effect of the corresponding surgical treatment according to the patient’s own condition in elderly patients with colon cancer and intestinal obstruction. Methods Sixty-eight patients admitted to Changzhou Lijiang Autonomous County People’s Hospital from October 2012 to October 2015 were selected, including 26 emergency patients, 42 patients undergoing elective surgery, 24 patients undergoing primary resection of intestinal anastomosis, Twenty-three patients underwent resection of intestinal anastomosis in line Ⅱ, 21 patients underwent enterostomy. Comparative analysis of patients after surgery, and at different times, different surgical complications occurred. Results Of the 68 patients, 65 (95.6%) were cured and 3 died (4.4%) after surgery. The incidence of postoperative complications (30.8%) was significantly higher than that of elective surgery (4.8%), the difference was statistically significant (P <0.05). The incidence of tumor resection anastomosis in stage Ⅰ (33.3%) was significantly higher than that in stage Ⅱ resection intestinal anastomosis (4.3%) and enterostomy (4.8%), the difference was statistically significant ( P <0.05). Conclusion For elderly patients with colon cancer and intestinal obstruction should be based on the specific circumstances of patients to determine a reasonable operation time and manner, do a good job in prevention of complications, improve the therapeutic effect.