左半结肠癌急性肠梗阻的两种一期切除吻合方法比较
结肠次全切除术,术中灌洗术,一期吻合术The,comparison,of,two,operation
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【摘要】目的探讨左半结肠癌急性肠梗阻行结肠次全切除术(subtotal colectomy，SC)和术中灌洗一期吻合术(intraoperative colonic irrigation，ICI)的临床意义。方法对比分析采用结肠次全切除术和术中灌洗一期吻合术治疗左半结肠癌致肠梗阻患者的疗效。结果SC组手术时间明显缩短，切口感染发生率低(SC组3例，占15.00%；ICI组4例，占10.53%；P<0.05)，出血量增多[SC组出血量(132±56)ml，ICI组(100±32)ml，P<0.05]，并出现顽固性腹泻；在住院时间和吻合口瘘发生率方面与ICI组比较无明显差别。结论以并发症吻合口瘘为主要考虑因素的话，笔者更倾向于术中灌洗一期吻合作为急诊左半结肠癌致肠梗阻手术处理的首选，但对患者应有选择性。
【关键词】左半结肠癌；肠梗阻；结肠次全切除术；术中灌洗术；一期吻合术The comparison of two operation mode in primary anastomosis for obstructing carcinoma of the left colon LUO Yu-qing,YUAN Yang-chun LIN Jia-yu.The Peoples Hospital of Jieyang City,Jieyang 522000,China
【Abstract】ObjectiveTo investigate the clinical value of subtotal colectomy(SC) and primary anastomosis after intraoperative colonic irrigation (ICI) for obstructing carcinoma of left colon.MethodsFifty eight patients were divided into subtotal colectomy group (20 patients,SC group) and primary anastomosis with intraoperative colonic irrigation group(38 patients,ICI group).The efficacy of SC and ICI was compared.ResultsIn SC group,mean operating time was significantly shorter,the infection rate of wound was 15.00% in SC group and 10.53% in ICI group(P<0.05).Bleeding capacity was increasing with(132±56)ml in SC group and(100±32)ml in ICI group(P<0 ......
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