李智伟　徐忠法

[摘要] 目的 對比分析结肠癌患者采用腹腔镜和开腹两种手术方式进行治疗的临床效果，和术后早期炎性肠梗阻情况。方法 方便选取2015年6月—2017年6月在该院就诊需要进行根治手术的72例结肠癌患者，以随机分组法分为对照组和治疗组，平均每组36例。对照组实施常规开腹结肠癌根治术治疗；治疗组实施腹腔镜结肠癌根治术治疗。比较两组术后早期炎性肠梗阻发生情况、手术操作时间、术后排气时间、术后住院时间、结肠癌手术效果、手术后不同时间点的VAS疼痛程度评分水平。结果 治疗组患者仅有2例术后早期炎性肠梗阻事件发生，少于对照组的8例（χ2=4.38，P<0.05）；手术操作时间（178.34±32.71）min、术后排气时间（32.24±12.72）h、术后住院时间（10.36±2.10）d短于对照组（206.82±42.25）min、（64.39±14.05）h、（16.34±2.58）d（t=29.613 8，30.261 9，13.342 8，P<0.05）；结肠癌手术治疗总有效率为91.7%，高于对照组的69.4%（χ2=4.64，P<0.05）；手术后不同时间点的VAS疼痛程度评分水平改善幅度[术后当天（7.31±0.49）分，术后3 d（3.01±0.55）分，t=11.997 6）]大于对照组[术后当天（7.54±0.86）分，术后3 d （5.62±0.63）分，t=11.034 2）]（P<0.05）。结论 结肠癌患者采用腹腔镜手术方式进行治疗，可以明显降低术后早期炎性肠梗阻事件的发生概率，缩短临床治疗时间，减轻患者疼痛，使治疗效果明显提高。

[关键词] 结肠癌；腹腔镜；开腹；术后；早期；炎性肠梗阻

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）04（c）-0075-03

Analysis of Comparison of Early Inflammatory Intestinal Obstruction after the Laparoscope and Radical Operation of Colon Cancer

LI Zhi-wei1，2，3，XU Zhong-fa1，2

1.Academy of Medicine and Life Sciences， Shandong Academy of Medical Sciences， Jinan University， Jinan， Shandong Province， 250200 China；2.Affiliated Hospital of Shandong Academy of Medical Sciences， Jinan University， Jinan， Shandong Province， 250031 China；3.Licheng Hospital of TCM， Jinan， Shandong Province， 250012 China

[Abstract] Objective To compare and analyze the clinical effect of early inflammatory intestinal obstruction after the Laparoscope and Radical operation of colon cancer. Methods 72 cases of patients with carcinoma of colon needing radical surgery in our hospital from June 2015 to June 2017 were selected and randomly divided into two groups with 36 cases in each， the control group were treated with routine radical operation of colon cancer， while the treatment group were treated with laparoscope operation of colon cancer， and the occurrence of early inflammatory intestinal， operation time， postoperative exhaust time， postoperative length of stay， operation effect of colon cancer and VAS pain degree scores at different time points were compared between the two groups. Results There were only 2 cases with early inflammatory intestinal obstruction events， which were lower than that in the control group （ 8 cases） （χ2=4.38， P< 0.05） ； and the operation time， exhaust time after surgery and postoperative length of stay were shorter than those in the control group， [（178.34±32.71）min， （32.24±12.72）h，（10.36±2.10）d vs （206.82±42.25）min， （64.39±14.05）h， （16.34±2.58）d]，（t=29.613 8，30.261 9，13.342 8，P<0.05）， and the total effective rate of surgery was higher than that in the control group， （91.7% vs 69.4%）， （χ2=4.64，P<0.05）， and the improvement ranges of VAS pain degrees at different time points after surgery were bigger than those in the control group， [on the day after surgery（7.31±0.49）points， on the third day after surgery （3.01±0.55）points， t=11.997 6 vs on the day after surgery （7.54±0.86）points， on the third day after surgery （5.62±0.63）points， t=11.034 2]（P<0.05）. Conclusion The laparoscopic surgery in treatment of patients with colon cancer can obviously reduce the occurrence probability of early inflammatory intestinal events， relieve the pains of patients and obviously improve the treatment effect.

[Key words] Colon cancer； Laparoscope； Laparotomy； Postoperative； Early； Inflammatory intestinal obstruction

结肠癌近年来已经成为发病率水平较高的恶性肿瘤类疾病的一种，目前临床对导致其发病的具体原因还不是十分的清楚，大多数学者在研究后认为与高脂、高肉食、低纤维饮食、遗传、肠道息肉、肠道炎症等因素有一定的关系，乙状结肠位置发生该类病变的可能性较大，该疾病患者的临床发病率与死亡率均处于相对较高的水平，广大患者的正常生活会受到严重影响[1-2]。该文对比2015年6月—2017年6月收治的72例结肠癌患者采用腹腔镜和开腹两种方式治疗的效果，和术后早期炎性肠梗阻情况，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的需要进行根治手术的72例结肠癌患者，以随机分组法分为对照组和治疗组，平均每组36例。……