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目的对比分析不同手术时机及术式对结肠癌所导致的急性肠梗阻患者的临床治疗效果,为临床应用提供参考。方法选取2012年11月~2014年12月来我院就诊的因结肠癌所导致的30例急性肠梗阻患者,回顾分析相关手术时机、手术术式及治疗效果。结果 22例予以改良的Dudley术进行灌洗,无感染情况;8例予以传统Dudley灌洗,1例出现腹腔感染。2例患者因腹膜炎立即实施一期切除吻合术,术后治愈无死亡;26例患者经过8~12h的保守治疗后予以一期切除吻合术,术后治愈且无死亡;2例经保守治疗2~3d后予以一期切除吻合术,1例术后死亡,1例治愈。左半结肠癌患者有1例吻合口瘘,1例死亡,右半结肠癌患者无吻合口瘘、无死亡。结论论结肠癌所导致的急性肠梗阻患者需要合适的手术时机以及正确的手术方式,才能达到良好的治疗效果。
Objective To compare and analyze the clinical effect of different operation timing and operation on patients with acute intestinal obstruction caused by colon cancer and provide reference for clinical application. Methods Thirty patients with acute intestinal obstruction due to colon cancer who visited our hospital from November 2012 to December 2014 were retrospectively analyzed on the timing of operation, operation procedure and treatment effect. Results Twenty-two patients underwent modified Dudley’s surgery for lavage without infection. Eight patients underwent traditional Dudley lavage and one had abdominal infection. 2 patients were treated with peritonitis immediately after a period of resection and anastomosis, postoperative cure without death; 26 patients after 8 ~ 12h after conservative treatment to be a resection and anastomosis, postoperative cure and no death; 2 cases of conservative treatment 2 After a ~ 3d resection and anastomosis, 1 patient died, 1 patient was cured. One patient with left-sided colon cancer had anastomotic fistula, and one patient died of right-colon cancer without anastomotic fistula and no death. Conclusions On the patients with acute intestinal obstruction caused by colon cancer, appropriate operation timing and proper operation method are needed in order to achieve good therapeutic effect.