脾曲远端结直肠癌合并肠梗阻经肛肠梗阻导管置入治疗47例分析

目的探讨经肛肠梗阻导管置入治疗脾曲远端结直肠癌合并肠梗阻的可行性,同时评价其安全性。方法回顾性分析2009年7月至2013年6月收治的脾曲远端结直肠癌合并肠梗阻患者93例,其中传统手术治疗组46例,肛肠梗阻导管置入组47例,采用统计学软件SPSS 16.0对记录的临床数据进行分析,计量资料采用t检验,用(x珋±s)表示;计数资料采用χ2检验,P0.05表示差异具有统计学意义。结果肛肠梗阻导管置入组患者的腹围周长、腹内压、梗阻近端肠管的最大横径明显减小,胃管、导管引流量明显减少,与置管前比较差异显著,均具有统计学意义(P均0.05);肛肠梗阻导管置入组腹部症状的缓解率达到93.62%且明显高于传统手术治疗组(10.87%);肛肠梗阻导管置入组并发症发生率、总住院时间、总住院费用也明显低于传统手术治疗组(P均0.05)。结论经肛肠梗阻导管置入治疗脾曲远端结直肠癌合并肠梗阻,取得十分显著的临床疗效,提高患者的存活率和康复率,安全有效,应在临床上大力推广使用。

Clinical application of anorectal ileus tube,report of 47 cases in treating colon cancer at the distal splenic flexure complicated with intestinal obstruction

Objective To investigate the feasibility of placement of anorectal ileus tube to treat patients with colon cancer involving the distal splenic flexure complicated with intestinal obstruction . Methods We retrospectively studied 93 patients with colorectal cancer involving the distal splenic flexure complicated with intestinal obstruction .These patients were treated in our hospital from July 2009 to June 2013.The 93 patients were divided into a traditional surgical group (46 patients ) and an anorectal ileus tube placement group ( 47 ). Their clinical data were analyzed using statistical software SPSS 16.0. Measurement data were checked by Student ’ s t test and represented as mean ±SD.Count data were checked by the Chi-square test, and P<0.05 was considered as statistically significant . Results Waist circumference , abdominal pressure , and obstruction of the proximal intestine in the anorectal ileus tube placement group were significantly reduced .The cases of gastric tube ( catheter ) drainage were also significantly reduced (all P<0.05).The remission rate of abdominal symptoms in the anorectal ileus tube placement group was up to 93.62% , which was significantly higher than that in the traditional surgical group (10.87%).The incidence of complications , total hospitalization time and total hospitalization costs in the anorectal ileus tube placement group were significantly lower than those in the traditional surgical treatment group (all P<0.05). Conclusion Anorectal ileus tube placement is effective in the treatment of patients with colorectal cancer at the distal splenic flexure complicated with intestinal obstruction .