郑小平　贺旭东　范月秀

[摘要]目的 比较腹腔镜手术和开腹手术治疗结直肠癌的临床效果。方法 将2014年1月～2016年1月在我院行手术治疗的132例结直肠癌患者根据手术方式分为两组，各66例。研究组患者接受腹腔镜手术治疗，对照组接受开腹手术治疗，比较两组患者的术中情况、术后恢复情况及并发症发生情况。结果 与对照组比较，研究组患者的手术时间明显较长，差异有统计学意义（P<0.01），但手术切口长度明显较短，且术中失血量较少，输血患者比例较低，差异有统计学意义（P<0.01）；两组患者术中淋巴结清扫数目差异无统计学意义（P>0.05）。与对照组比较，研究组患者术后肠鸣音恢复时间、下床活动时间及住院时间均明显较短，差异有统计学意义（P<0.01），且术后止痛药的使用比例较低，差异有统计学意义（P<0.05）。研究组患者的术后并发症总发生率为9.1%，明显低于对照组的34.8%，差异有统计学意义（P<0.01）。结论 与开腹手术比较，腹腔镜手术治疗结直肠癌的效果肯定，创伤小，并发症少，安全性高。

[关键词]腹腔镜手术；开腹手术；结直肠癌；临床疗效；并发症

[中图分类号] R735.3 [文献标识码] A [文章编号] 1674-4721（2017）07（b）-0068-03

[Abstract]Objective To compare the clinical effect of laparoscopic operation and laparotomy in treatment of colorectal cancer.Methods 132 patients with colorectal cancer given surgical treatment in our hospital from January 2014 to January 2016 were divided into two groups according to the operation method，and 66 patients were included in each group.The research group was given laparoscopic surgery，and the control group was given laparotomy；The intraoperative condition，postoperative recovery and complications between the two groups were compared.Results Compared with the control group，the surgical time of the research group was significantly longer （P<0.01），but the incision length was significantly shorte，intraoperative blood loss was significantly less and blood transfusion proportion of patients was lower （P<0.01）.The difference between two groups on intraoperative lymph node cleaning number was not statistically significant （P>0.05）.Compared with the control group，the post-operative bowel sound recovery time，bed activity time and hospital stay of the research group were significantly shorter （P<0.01），and the usage proportion of postoperative analgesic drug was less （P<0.05）.The total incidence rate of postoperative complication of the research group was 9.1%，which was significantly less than that of the control group （34.8%） （P<0.01）.Conclusion Compared with the laparotomy，the curative effect of laparoscopic surgery treating colorectal cancer is definite and it has disadvantages of smaller trauma，fewer complications and higher security.

[Key words]Laparoscopic operation；Laparotomy；Colorectalcancer；Clinical curative effect；Complication

結直肠癌是常见的消化道肿瘤，好发于中老年人，发病率居恶性肿瘤前5位，由于我国人民群众生活习惯及饮食结构的改变，结直肠癌的发病率仍呈上升趋势[1-2]。根治性手术是治疗结直肠癌的主要方法；传统开腹手术对患者造成的创伤较大，故近年来，腹腔镜下结直肠癌根治术逐渐受到广泛应用[3-4]。本文回顾性分析在我院行手术治疗的132例结直肠癌患者的临床资料，探讨两者的疗效及并发症发生情况，现报道如下。

1资料与方法

1.1一般资料

将2014年1月～2016年1月在我院行手术治疗的132例结直肠癌患者作为研究对象，回顾性分析其临床资料，根据手术方式分为研究组和对照组，各66例。研究组中男性40例，女性26例；平均年龄为（58.2±8.6）岁；肿瘤平均直径为（4.0±0.7）cm；肿瘤分布：直肠19例，乙状结肠12例，横结肠8例，升结肠22例，降结肠5例；……