金属支架置入术治疗左半结肠癌合并梗阻疗效分析

目的 探讨经内镜自膨式金属支架置入术在左半结肠癌合并梗阻术前的应用价值。方法 选择2009年1月~2015年1月我院收治的左半结肠癌合并肠梗阻患者84例，根据随机数字表法分为两组，每组42例。观察组采取术前支架置入术，对照组采用传统手术治疗，对比两组的手术时间、术中出血量、术后排气时间、术后并发症发生率、平均住院时间、腹腔引流时间以及生存期死亡率。结果 观察组腹腔镜手术率为90.47%（38/42），Ⅰ期切除吻合率为97.61%（41/42），均高于对照组（P＜0.05）；两组手术时间比较无统计学差异（P＞0.05），观察组术中出血量（68.41±20.47）ml少于对照组的（125.25±20.13）ml （P＜0.05），术后排气时间（2.81±0.42）d短于对照组（4.50±0.33）d（P＜0.05）；观察组并发症发生率（14.29%）低于对照组（40.48%）（P＜0.05）；观察组腹腔引流时间短于对照组（P＜0.05）。对照组3年、5年死亡率分别为14.29%、30.95%，平均生存期（48.20±13.13）个月，高于观察组的4.76%、11.90%、（67.41±15.93）个月，（P均＜0.05）。结论 左半结肠癌合并梗阻，术前采用经内镜自膨式金属支架置入术，可以有效提高I期吻合率，减少术中出血量，并显著降低并发症发生率，促进术后恢复。

Therapeutic Effect of Metal Stent Placement in the Treatment of Left Colon Cancer with Obstruction

Objective To evaluate the value of endoscopic self-expanding metal stent placement in the treatment of left colon cancer with obstruction.Methods From January 2009 to January 2015, 84 patients with left colon cancer and intestinal obstruction admitted to our hospital were randomly divided into two groups according to the digital table method, 42 cases in each group. The observation group underwent preoperative stenting, and the control group was treated with conventional surgery. The operation time, intraoperative blood loss, postoperative exhaust time, postoperative complication rate, average hospital stay, abdominal drainage time, and Survival mortality. Results The laparoscopic surgery rate was 90.47%, and the stage I resection rate was 97.61%, which was higher than 26.19% and 26.19% of the control group (P<0.05). There was no significant difference in operation time between the two groups (P>0.05), the intraoperative blood loss (68.41±20.47) ml in the observation group was lower than that in the control group (125.25±20.13) ml (P<0.05), and the postoperative exhaust time (2.81±0.42) d was shorter than the control group (4.50±0.33) d(P<0.05); the incidence of complications in the observation group (14.29%) was lower than that in the control group (40.48%)(P<0.05). The drainage time in the observation group was shorter than that in the control group (P<0.05). The 3-year and 5-year mortality rates of the control group were 14.29% and 30.95%, respectively, and the average survival time was (48.20±13.13) months, which was higher than the observation group's 4.76%, 11.90%, and (67.41±15.93) months (P<0.05). Conclusion Left colon cancer with obstruction and endoscopic self-expanding metal stent placement can effectively improve the rate of I-stage anastomosis, reduce the amount of intraoperative blood loss, and significantly reduce the incidence of complications and promote postoperative recovery.