单汉国　黄笛鸣　王春云

[摘要] 目的 分析回腸袢式造口术与结肠造口术治疗老年梗阻性乙状结肠癌和高位直肠癌的临床效果。 方法 将2014年1月～2017年1月收治的80例老年梗阻性乙状结肠癌和高位直肠癌患者作为研究对象，根据随机数字表将患者分为两组，每组40例。结肠造口组采用结肠造口术治疗，回肠袢式造口组采用回肠袢式造口术治疗。比较两组梗阻性乙状结肠癌和高位直肠癌治疗效果，第一次排气时间、手术时间，干预前后患者生存质量水平、T淋巴细胞亚群指标，并发症发生率。 结果 回肠袢式造口组梗阻性乙状结肠癌和高位直肠癌治疗总有效率为77.50%，高于结肠造口组的50.00%（P<0.05）；回肠袢式造口组第一次排气时间、手术时间分别为（23.51±1.41）h、（54.51±12.61）min，短于结肠造口组的（34.40±2.77）h、（77.40±23.57）min，差异有统计学意义（P<0.05）；干预前两组生存质量水平、T淋巴细胞亚群指标相近（P>0.05）；干预后回肠袢式造口组生存质量水平、T淋巴细胞亚群指标优于结肠造口组（P<0.05）。回肠袢式造口组并发症发生率为7.50%，低于结肠造口组的20.00%（P<0.05）。 结论 回肠袢式造口术治疗老年梗阻性乙状结肠癌和高位直肠癌的临床效果优于结肠造口术治疗，可改善预后，对细胞免疫功能影响不大，可缩短手术和排气时间，减少并发症发生率，促进患者生存质量的提升，值得推广。

[关键词] 回肠袢式造口术；结肠造口术；老年梗阻性乙状结肠癌；高位直肠癌

[中图分类号] R735.3 [文献标识码] B [文章编号] 1673-9701（2017）23-0042-03

[Abstract] Objective To analyze the clinical effect of ileal loop colostomy and colostomy in the treatment of obstructive sigmoid colon carcinoma and high rectal cancer. Methods A total of 80 patients with senile obstructive sigmoid colon carcinoma and high rectal cancer from January 2014 to January 2017 were enrolled in this study. They were grouped according to the random number table， with 40 patients in each group. Colostomy group was given colostomy treatment， ileal loop-type colostomy group was treated with ileum loop colostomy treatment. The therapeutic effects， the first exhaust time， the operation time of obstructive sigmoid colon cancer and high rectal cancer between the two groups were compared. The quality of life of patients before and after the intervention， the T lymphocyte subpopulation index and the incidence of complications between the two groups were compared. Results The treatment effect of obstructive sigmoid colon carcinoma and high rectal cancer was 77.50%， higher than that in colostomy group（50.00%） （P<0.05）. The first exhaust time and the operation time was（23.51±1.41） h， （54.51±12.61） min respectively， shorter than that of colostomy group[（34.40±2.77） h， （77.40±23.57） min]（P<0.05）. The quality of life and the T lymphocyte subsets were similar in the two groups before intervention（P>0.05）. The level of the quality of life and T-lymphocyte subsets in the ileal loop colostomy group were superior to that of colostomy group after intervention（P<0.05）. The incidence of complication was 7.50% in the ileal colostomy group， lower than 20.00% in the colostomy group（P<0.05）. Conclusion The clinical effect of ileal loop colostomy in the treatment of obstructive sigmoid colon cancer and high rectal cancer is superior to that of colostomy. And the ileal loop colostomy can improve the prognosis and has little effect on cellular immune function， which can shorten the operation and exhaust time， and can reduce the occurrence of complications. It promotes the quality of life of patients to enhance and is worth promoting.endprint

[Key words] Ileal loop colostomy； Colostomy； Senile obstructive sigmoid colon carcinoma； High rectal cancer

老年梗阻性乙状结肠癌和高位直肠癌发病率高，是常见消化道恶性肿瘤，多数患者就诊时处于晚期，加上慢性疾病多，预后较差[1-2]。目前老年梗阻性乙状结肠癌和高位直肠癌多采用手术方法治疗，但手术术式较多，需选择安全性高、疗效好的术式。回肠袢式造口术与结肠造口术是老年梗阻性乙状结肠癌和高位直肠癌常见术式，为了对比两者的效果，本研究将将2014年1月～2017年1月80例老年梗阻性乙状结肠癌和高位直肠癌患者作为研究对象并根据随机数字表分组，每组40例，探讨回肠袢式造口术与结肠造口术治疗老年梗阻性乙状结肠癌和高位直肠癌的临床效果，现报道如下。……