經腸鏡下支架置入聯合腹腔鏡手術治療結直腸癌并腸梗阻效果的臨床分析

譚杰

[摘要] 目的 研究結直腸癌并腸梗阻患者應用經腸鏡下支架置入聯合腹腔鏡手術治療的效果。 方法 方便抽取88例2017年3月—2018年3月該院收治的結直腸癌并腸梗阻患者，將患者分為參考組（n=42）和探討組（n=46），參考組患者應用腹腔鏡手術治療，探討組患者應用腹腔鏡聯合腸鏡支架治療，對比分析2組患者手術情況以及并發癥情況。 結果探討組患者手術時間為（324.8±22.9）min、淋巴結清掃數目為（13.9±3.2）枚、術后肛門排氣時間為（1.7±1.0）d、住院時間為（9.3±1.6）d，參考組患者手術時間為（311.9±23.5）min、淋巴結清掃數目為（8.1±2.9）枚、術后肛門排氣時間為（3.3±1.2）d、住院時間為（19.3±1.7）d。與參考組患者相比，探討組患者手術時間明顯更短，差異有統計學意義（t=25.290 6，P=0.017 2），術后肛門排氣時間更短，差異有統計學意義（t=8.206 2，P=0.017 3），住院時間明顯更短，2組差異有統計學意義（t=10.829 4，P=0.042 9），探討組患者淋巴結清掃數目明顯更多，2組差異有統計學意義（t=14.728 3，P=0.039 1）。探討組患者并發癥總發生率明顯較參考組低，2組差異有統計學意義（χ2=16.391 0，P=0.019 6），其中，探討組共計3例患者出現并發癥，總發生率為6.52%，參考組共計8例患者出現并發癥，總發生率為19.05%。 結論 結直腸癌并腸梗阻患者應用經腸鏡下支架置入聯合腹腔鏡手術治療能夠取得確切療效，可使術后并發癥發生率得到顯著降低，臨床應用安全性較高。

[關鍵詞] 經腸鏡下支架置入；腹腔鏡手術；結直腸癌；腸梗阻

[中圖分類號] R735.34 [文獻標識碼] A [文章編號] 1674-0742（2019）01（b）-0039-03

[Abstract] Objective To study the effect of endoscopic stent placement combined with laparoscopic surgery for patients with colorectal cancer and intestinal obstruction. Methods 88 patients with colorectal cancer and intestinal obstruction admitted to our hospital from March 2017 to March 2018 were convenient selected and enrolled. The patients were divided into reference group （n=42） and discussion group （n=46）. The control group was treated with the mirror surgery， the patients in the study group were treated with laparoscopic and colonoscopy， and the operation and complications of the two groups were compared. Results The operation time of the study group was （324.8±22.9）min， the number of lymph node dissection was （13.9±3.2）， the postoperative anal exhaust time was （1.7±1.0）d， and the hospital stay was （9.3±1.6）d. The operation time of the patients was （311.9±23.5）min， the number of lymph node dissection was （8.1±2.9）， the postoperative anal exhaust time was （3.3±1.2） d， and the hospital stay was（19.3±1.7）d. Compared with the control group， the operation time of the study group was significantly shorter， the difference was statistically significant （t=25.290 6， P=0.017 2）， and the postoperative anal exhaust time was shorter， the difference was statistically significant （t=8.206 2， P=0.017 3）， the hospitalization time was significantly shorter， the difference between the two groups was statistically significant （t=10.829 4， P=0.042 9）. The number of lymph node dissection in the study group was significantly more， and the difference between the two groups was statistically significant （t=14.728 3， P=0.039 1）. The total incidence of complications in the study group was significantly lower than that in the reference group. There was a statistically significant difference between the two groups （χ2=16.391 0， P=0.019 6）. Among them， 3 patients in the study group had complications， with a total incidence of 6.52%. A total of 8 patients in the control group had complications， with a total incidence of 19.05%. Conclusion In patients with colorectal cancer and intestinal obstruction， endoscopic stent placement combined with laparoscopic surgery can achieve definite curative effect， which can significantly reduce the incidence of postoperative complications and high clinical safety.