经内镜自膨式金属支架置入术在结肠癌并梗阻手术前应用价值-内科学(消化系病)专业毕业论文.pdfVIP

福建医科大学硕士毕业论文 经内镜自膨式金属支架置入术在结肠癌并梗阻手术 前应用价值 中文摘要 目的： 探讨经内镜自膨式金属支架置入术在结肠癌并梗阻中作为术前准备的应用 价值。 方法： 回顾本院自2007 年07 月至 2010 年 11 月收治的结肠癌并梗阻73 例患者 的临床资料，其中14 例术前行支架置入术，其余采用传统术前准备后手术，比 较两组手术方式选择、手术时间、术中出血、术后并发症发生率、术后住院时 间、术后腹腔引流时间、术后禁食天数、生存曲线等的区别。 结果： 两组比较性别、年龄、肿块部位、伴发疾病、病理分期等基本资料无显著 差异(P0.05)。支架组经腹腔镜手术比例、I 期切除吻合率高于传统组，术中 出血量支架组低于传统组，支架组术后并发症发生率、术后住院时间、术后腹 腔引流时间、术后禁食天数均低于传统组，支架组生存曲线高于传统组，上述 比较差异均有统计学意义(p0.05)。手术时间支架组高于传统组，但差异无统 计学意义(p0.05)。 结论： 经内镜自膨式金属支架置入术应用于结肠癌并梗阻术前准备，能为经腹腔 镜微创手术争取机会；能提高 I 期吻合率，尤其在左半结肠癌并梗阻中明显； 能减少手术中出血量，降低手术损伤；能降低手术后并发症发生率，促进术后 恢复速度；能在提高生存率中起一定作用；具有较高的临床应用价值。 关键词：结肠癌 梗阻 支架 内镜 1 福建医科大学硕士毕业论文 Application of endoscopic self-expandable metallic stents used as a “bridge to surgery” in obstructing colorectal cancer Abstract Objective：The aim of this study is to assess the clinical outcomes : endoscopic self-expandable metallic stents (SEMS) are being used as a “bridge to surgery” in obstructing colorectal cancer (CRC). Methods: Collected information of 73 patients with a diagnose of obstructing colorectal cancer from July 2007 to November 2010 in our hospital (Fujian Medical University Union Hospital), of which 14 ones were treated with endoscopic colonic stenting as a bridge to an elective resection (stent-group). The others were treated with surgery without stent (traditional-group). Compared the difference of surgical options, surgical time, blood loss, complication rate, postoperative hospitalization time, postoperative abdominal drainage time, postoperative fasting time and survival curves between the two groups. Results: The two groups were similar in terms of age, sex distribution, presence of co-morbidity,