结肠镜下肠道金属支架在左半结肠癌伴梗阻患者中的应用效果.docVIP

结肠镜下肠道金属支架在左半结肠癌伴梗阻患者中的应用效果 　　[摘要]目的 探讨结肠镜下肠道金属支架在左半结肠癌伴梗阻患者中的应用效果。方法 选取我院2015年3月～2016年3月收治的15例左半结肠癌伴梗阻患者为观察组，均给予结肠镜下肠道金属支架解除梗阻，再行手术切除肿瘤。另选取2014年1～12月收治的左半结肠癌伴梗阻患者15例为对照组，均行结肠造瘘解除梗阻，再行手术切除肿瘤，观察两组患者手术的效果。结果 观察组金属支架置入后患者腹围、胃肠减压量、近端结肠最大横径均较术前明显下降，差异有统计学意义（P0.01）；患者腹痛、腹胀症状均明显减少，肠鸣音恢复正常时间为（3.3±0.6）d，肠梗阻症状完全缓解时间为（8.6±0.3）d。所有患者均行开腹手术，术中肠管基本无扩张和水肿，肠腔内无明显粪渣，未发生术后吻合口瘘及切口感染，均经保守治一期切除吻合获愈。观察组未发生术后吻合口瘘和其他并发症，对照组术后吻合口瘘发生率为20.0%，并发症发生率为33.3%，观察组并发症发生率明显低于对照组，组间比较，差异有统计学意义（P0.05）；观察组住院费用（14 963.9±1563.7）元，住院时间（17.9±2.2）d，对照组住院费用（29 613.7±3697.2）元，住院时间（31.6±5.9）d，组间比较，差异有统计学意义（P0.01）。结论 结肠镜下肠道金属支架解除梗阻后再行手术，能达到一期切除，降低吻合口瘘及并发症的发生率，有助于减轻患者经济负担。 　　[关键词]结肠镜；金属支架；结肠癌；梗阻 　　[中图分类号] R735.3+5 [文献标识码] A [文章编号] 1674-4721（2016）08（a）-0109-03 　　[Abstract]Objective To explore the application effect of intestinal metal stent in the patients with left hemicolon carcinoma complicated with obstruction under colonoscopy.Methods 15 patients with left hemicolon carcinoma complicated with obstruction who were admitted to our hospital from March 2015 to March 2016 were selected as observation group.They were given intestinal metal stent under colonoscopy to alleviate obstruction，and they were further given surgery to remove the tumor.Another 15 patients with left hemicolon carcinoma complicated with obstruction who were admitted to our hospital from January 2014 to December 2014 were selected as control group.They were given colostomy to alleviate obstruction，and they were further given surgery to remove tumor.The surgical effects were observed in both groups.Results After implantation of metal stent，abdominal girth，gastrointestinal decompression volume，and maximum transverse diameter of proximal colon in observation group were respectively reduced compared with that before the surgery（P 　　[Key words]Colonoscopy；Metal stent；Colon cancer；Obstruction 　　左半结肠癌是临床常见疾病，其特征是肿瘤体积小，临床主要表现为腹部绞痛、排便困难、血便等症状，严重影响患者的正常生活和工作。左半结肠肠管较右半结肠肠管更加狭窄，因此，若左半结肠肿瘤，特别是恶性肿瘤发生梗阻的可能性更大。针对左半结肠癌伴梗阻患者的治疗，关键在于快速解除梗阻，促进胃肠动力恢复，改善患者