经肠镜下支架置入联合腹腔镜手术治疗结直肠癌并肠梗阻效果的临床分析

谭杰

[摘要] 目的 研究結直肠癌并肠梗阻患者应用经肠镜下支架置入联合腹腔镜手术治疗的效果。 方法 方便抽取88例2017年3月—2018年3月该院收治的结直肠癌并肠梗阻患者，将患者分为参考组（n=42）和探讨组（n=46），参考组患者应用腹腔镜手术治疗，探讨组患者应用腹腔镜联合肠镜支架治疗，对比分析2组患者手术情况以及并发症情况。 结果探讨组患者手术时间为（324.8±22.9）min、淋巴结清扫数目为（13.9±3.2）枚、术后肛门排气时间为（1.7±1.0）d、住院时间为（9.3±1.6）d，参考组患者手术时间为（311.9±23.5）min、淋巴结清扫数目为（8.1±2.9）枚、术后肛门排气时间为（3.3±1.2）d、住院时间为（19.3±1.7）d。与参考组患者相比，探讨组患者手术时间明显更短，差异有统计学意义（t=25.290 6，P=0.017 2），术后肛门排气时间更短，差异有统计学意义（t=8.206 2，P=0.017 3），住院时间明显更短，2组差异有统计学意义（t=10.829 4，P=0.042 9），探讨组患者淋巴结清扫数目明显更多，2组差异有统计学意义（t=14.728 3，P=0.039 1）。探讨组患者并发症总发生率明显较参考组低，2组差异有统计学意义（χ2=16.391 0，P=0.019 6），其中，探讨组共计3例患者出现并发症，总发生率为6.52%，参考组共计8例患者出现并发症，总发生率为19.05%。 结论 结直肠癌并肠梗阻患者应用经肠镜下支架置入联合腹腔镜手术治疗能够取得确切疗效，可使术后并发症发生率得到显著降低，临床应用安全性较高。

[关键词] 经肠镜下支架置入；腹腔镜手术；结直肠癌；肠梗阻

[中图分类号] R735.34 [文献标识码] A [文章编号] 1674-0742（2019）01（b）-0039-03

[Abstract] Objective To study the effect of endoscopic stent placement combined with laparoscopic surgery for patients with colorectal cancer and intestinal obstruction. Methods 88 patients with colorectal cancer and intestinal obstruction admitted to our hospital from March 2017 to March 2018 were convenient selected and enrolled. The patients were divided into reference group （n=42） and discussion group （n=46）. The control group was treated with the mirror surgery， the patients in the study group were treated with laparoscopic and colonoscopy， and the operation and complications of the two groups were compared. Results The operation time of the study group was （324.8±22.9）min， the number of lymph node dissection was （13.9±3.2）， the postoperative anal exhaust time was （1.7±1.0）d， and the hospital stay was （9.3±1.6）d. The operation time of the patients was （311.9±23.5）min， the number of lymph node dissection was （8.1±2.9）， the postoperative anal exhaust time was （3.3±1.2） d， and the hospital stay was（19.3±1.7）d. Compared with the control group， the operation time of the study group was significantly shorter， the difference was statistically significant （t=25.290 6， P=0.017 2）， and the postoperative anal exhaust time was shorter， the difference was statistically significant （t=8.206 2， P=0.017 3）， the hospitalization time was significantly shorter， the difference between the two groups was statistically significant （t=10.829 4， P=0.042 9）. The number of lymph node dissection in the study group was significantly more， and the difference between the two groups was statistically significant （t=14.728 3， P=0.039 1）. The total incidence of complications in the study group was significantly lower than that in the reference group. There was a statistically significant difference between the two groups （χ2=16.391 0， P=0.019 6）. Among them， 3 patients in the study group had complications， with a total incidence of 6.52%. A total of 8 patients in the control group had complications， with a total incidence of 19.05%. Conclusion In patients with colorectal cancer and intestinal obstruction， endoscopic stent placement combined with laparoscopic surgery can achieve definite curative effect， which can significantly reduce the incidence of postoperative complications and high clinical safety.