陈坚锋，陈福坤

(上虞市人民医院，浙江 上虞 312300)

·基础与临床研究·

乙状结肠癌急性梗阻一期切除吻合64例治疗体会

陈坚锋，陈福坤

(上虞市人民医院，浙江 上虞 312300)

目的：评价乙状结肠癌伴急性梗阻一期切除吻合术的治疗效果，探讨一期切除吻合手术的可行性及有效性。方法对本院自2002年7月至2011年6月期间患乙状结肠癌伴急性梗阻行一期切除吻合术的64例作回顾性分析。结果本组中无死亡病例，无再次手术情况，术后出现吻合口漏1例，经双套管冲洗引流后短期内愈合，盆腔脓肿1例，经穿刺后吸收愈合，切口感染2例，经局部换药短期内愈合。结论对符合手术切除指证的乙状结肠癌伴急性梗阻患者行一期切除吻合术具有较好的效果。

乙状结肠癌；急性梗阻；一期切除吻合

Abstract: [Objective] To assess the therapeutic effect of anastomsis resection in sigmoid colon cancer with primary-stage acute obstruction as to explore its feasibility and effectiveness. [Method] Retrospective analysis to 64 cases of sigmoid colon cancer with acute obstruction admitted into our hospital from July 2002 to June 2011, who were operated with anastomisis resection was carried out. [Result] Neither death case nor re-operation case were reported. One case with stomal leak after operation healed up in a short time after Double pipe flushing drainage. One case with pelvic abscess healed up after absorption with puncture. Two cases with incision infection healed up soon after local medicine change. [Conclusion] Anastomosis resection in sigmoid colon cancer treatment with primary-stage acute obstruction can be applied to patients who meet the requirement of excision and it is quite effective..

Keywords:sigmoid colon cancer; acute obstruction; primary-stage anastomsis resection

乙状结肠癌是大肠癌中较为常见的一种，临床中有10%～23%的大肠癌并发肠梗阻。乙状结肠癌在病情进展过程中具有突发性与隐匿性的特点，多引发低位性肠梗阻，通常会因为无法缓解而需要采取急诊或亚急诊外科手术治疗。我院对乙状结肠癌伴急性梗阻的患者采取一期手术切除吻合的外科手术方法，取得了较好的临床疗效，现报告如下。

1 资料与方法

1.1 临床资料

自2002年7月至2011年6月本院收治乙状结肠癌伴急性梗阻病例184例，选取行一期切除吻合术64例患者为研究对象。其中男性41例，女性23例，年龄42～82岁，平均67.58岁。入院时均有不同程度的腹痛，腹胀，肛门停排便排气等急性肠梗阻表现，出现腹膜刺激症状14例，腹腔穿刺抽出脓液或渗液6例，有穿孔或休克症状者3例。……