赵仕侠中核兰州铀浓缩公司医院外科，甘肃兰州　730065

左半结肠癌致肠梗阻一期根治36例分析

赵仕侠
中核兰州铀浓缩公司医院外科，甘肃兰州730065

目的 探讨左半结肠癌致肠梗阻后急诊肠镜检查，活检，经灌注冲洗一期根治吻合的可行性，评价其有效性，安全性及适应性。方法 选择2005年9月—2015年12月该院收治的左半结肠癌致肠梗阻患者70例为临床研究对象，根据患者治疗方法的不同分为传统治疗的对照组和一期根治术的观察组，对比两组患者的治疗效果及并发症。结果 实验组36例患者中除1例高龄患者因术中麻醉意外呼吸功能衰竭死亡外，35例患者顺利恢复，手术时间为（97.52±10.02）min，住院时间为（15.01±3.55）d，与对照组比较，P＜0.05，差异有统计学意义。结论 通过合理的肠道准备，行急诊电子结肠镜检查，活检明确诊断后，恰当的术中灌洗，正规静脉营养支持，行左半大肠癌一期根治效果良好，也有安全性，在肛肠科及医院中可推荐广泛应用。

左半结肠癌；肠梗阻；灌注冲洗；一期吻合

［Abstract］Objective To investigate the feasibility of radical resection and one-stage anastomosis caused by left colon cancer by means of emergency colonoscopy，biopsy and the Irrigation，and then to evaluate its effectiveness，safety and adaptability.Methods Selected September 2005 to December 2015 in our hospital obstruction of left colon cancer study of 70 patients with clinical，depending on the method of treatment were divided into conventional treatment group and an observation group of radical surgery，compared two groups of patients with treatment and complications.Results 36 patients except one case of anesthesia in elderly patients due to respiratory failure and death accident，the 35 patients recovered well，the operation time was（97.52±10.02）min，length of stay was（15.01±3.55）d，compared with the control group，P＜0.05，the difference was statistically significant.Conclusion Reasonable bowel preparation，underwent emergency electronic colonoscopy，biopsy diagnosis and appropriate intraoperative lavage，regular intravenous nutritional support，line a radical left colorectal good effect，but also security，in anorectal and hospitals can be widely recommended.

［Key words］Left colon cancer；Intestinal obstruction；The Irrigation；One-stage anastomosis

结肠癌是消化道常见恶性肿瘤疾病之一，起病隐匿，病程长，在我国发病率占恶性肿瘤第3位。结肠癌易引起急性肠梗阻，据有关报道并发急性肠梗阻发生率为8%～21%左右，结肠癌并发急性肠梗阻是普外科常见急腹症之一［1］，往往患者病情复杂，其治疗程序直接关系患者病情转归。一期切除吻合已成为梗阻性右半结肠癌的标准手术，但是对于梗阻性左半结肠癌的处理仍存在争议，既往手术方式以分期手术为主，但普遍存在诊治时间较长，预后较差等问题［2］。……