回肠袢式造口术和结肠造口术对老年左侧结直肠癌患者的临床疗效比较

目的观察回肠袢式造口术以及结肠造口术对老年左侧结肠癌患者的临床疗效对比。方法临床纳入老年结肠癌患者90例,根据随机数字表法分为回肠袢式造口术组与结肠造口术组,回肠袢式造口术组进行回肠袢式造口术,结肠造口术组进行结肠造口术。采用SPSS 16.0统计学软件进行数据处理,两组手术情况比较、血清胃泌素、肝细胞生长因子(HGF)水平采用t检验;两组患者术后并发症情况比较用(%)表示,χ~2检验,以P0.05为差异说明存在统计学意义。结果回肠袢式造口术组住院时间、首次排气时间、手术时间明显短于结肠造口术组(P0.05);血清胃泌素(59.3±24.2)pg/ml、HGF水平(853.6±94.9)pg/ml,均明显低于结肠造口术组(69.9±25.9)pg/ml、(1 009.6±100.3)pg/ml(t=2.01、7.59,P0.05);回肠袢式造口术组并发症感染率仅为2.2%(1/45),明显低于结肠造口术组的26.7%(12/45),(χ~2=10.88,P0.05);差异均有统计学意义。结论老年结肠癌患者采用回肠袢式造口术,患者术后恢复迅速,术后并发症低,临床效果确诊,值得临床推广。

Clinical efficacy of loop ileostomy and colostomy in treating elder patients with colorectal cancer at left side

Objective To compare the clinical efficacy of loop ileostomy and colostomy in treating elder patients with colorectal cancer at left side . Methods Ninety elderly patients with colorectal cancer were selected and randomly divided into a loop ileostomy group and a colostomy group .SPSS16.0 statistical software was used in assessing the factors during and after the operations and the levels of serum gastrin and HGF.Postoperative complications of the two groups were presented as rate (%) and tested by the Chi-square test.P<0.05 was considered statistically significant . Results The time for hospitalization , initial exhaust and operation in the loop ileostomy group was significantly shorter than that in the colostomy group ( P<0.05).The levels of serum gastrin and HGF in the loop ileostomy group were (59.3 ±24.2) pg/ml and (853.6 ±94.9) pg/ml respectively, whereas the levels in the colostomy group were (69.9 ±25.9) pg/ml and (1 009.6 ±100.3) pg/ml (t =2.01, 7.59, P<0.05).The incidence of complications related to infection in the loop ileostomy group (2.2%, 1/45) was significantly lower than that in the colostomy group (26.7%, 12/45) (χ2 =10.88, P<0.05). Conclusion Loop ileostomy should be applied to elderly patients with colorectal cancer as loop ileostomy could promote recovery and reduce the incidence of complications related to infection .