中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (03): 221-223.

• 论著 • 上一篇    下一篇

经肛肠梗阻导管置入清洗减压在急性梗阻性左半结直肠癌治疗中应用价值的研究

刘    祺，苏    冀，罗维珍，成世盈，刘升峰，陈超武，李    丹，黄忠诚   

  1. 湖南省人民医院普外科，湖南长沙410005
  • 出版日期:2010-03-01 发布日期:2010-03-12

  • Online:2010-03-01 Published:2010-03-12

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摘要：

目的    评价经肛肠梗阻导管置入清洗减压在急性梗阻性左半结直肠癌治疗中的临床疗效。 方法    总结湖南省人民医院2007年12月至2009年6月29例急性梗阻性左半结直肠癌病人，其中15例经肛置入肠梗阻导管，清洗减压10~20d后限期手术治疗，14例常规手术处理。对比观察两组手术方式、恢复情况、住院时间和费用情况。 结果    15例病人置管成功率100%，1例病人置管后3d导管不慎脱出，其余病人手术治疗前复查腹平片肠梗阻表现基本消失，手术均行一期根治性切除吻合；14例常规手术病人均需二期手术处理，两组病人术后均无严重并发症，置管组总住院时间短［（25.90±2.46）d vs （29.70±1.52）d，P<0.05］，总住院费用降低［（27500.00±2163.5342）元 vs （33200.00± 2512.4267）元，P<0.05］。 结论    经肛肠梗阻导管清洗减压在急性梗阻性左半结直肠癌治疗中安全、有效，可以避免病人二次手术打击的痛苦，有望成为治疗的首选措施。

关键词: 经肛肠梗阻导管, 结直肠癌, 急性梗阻

Abstract:

Clinical therapeutic effect of trans-anal ileus tube placement in acute obstruction result from left colorectal cancer        LIU Qi , SU Ji, LUO Wei-zhen, et al.  Department of General Surgery, the People’s Hospital of Hunan Province, Changsha 410005, China
Corresponding author: HUANG Zhong-cheng, E-mail: drliuqi@126. com
Abstract    Objective    To evaluate the clinical therapeutic effect of trans-anal ileus tube placement and drainage in acute obstruction result from left colorectal cancer. Method From Dec. 2007 to Jun. 2009, 29 patients of acute obstruction result from left colorectal cancer were admitted in the People’s Hospital of Hunan Province. 15 patients were received trans-anal ileus tube placement and drainage for 10 to 20 days before limited operation; and the other 14 patients were received emergency operation. The clinical effect, modus operandi, recovery effect, length of stay in hospital and the cost of hospitalization were observed in the two group patients.  Result 15 patients were placed the trans-anal ileus tube successfully. Besides 1 patient’s tube prolapsed negligently after three days, the others rechecked the abdomen X-rays and founded the bowel obstructive signs disappeared before radical excision without abdominal stoma. The other 14 patients who received emergency operation needed further surgery treatment. Two group patients had no severer complications and the tube placement group had shorter length of total stay in hospital［（25.90±2.46）d vs （29.70±1.52）d，P<0.05］and the lower cost of hospitalization［（27500.00±2163.5342）￥vs （33200.00± 2512.4267）￥，P<0.05］.  Conclusion Trans-anal ileus tube placement and drainage in acute obstruction result from left colorectal cancer could successfully avoid patients received surgical attack again. It was effective and safe and may be the first choice of clinical therapeutic.

Key words: trans-anal ileus tube, colorectal cancer, actue obstruction