内镜联合X线肠道支架置入对结肠癌伴急性肠梗阻手术影响分析
Modern Digestion & Intervention（2020）
Abstract
目的 探讨内镜联合X线下肠道金属支架置入对结肠癌伴急性肠梗阻手术影响.方法 回顾性分析2017年1月至2019年12月于蚌埠医学院第一附属医院因结肠癌伴急性肠梗阻行结肠金属支架置入并择期手术的20例患者,研究20例患者梗阻近期缓解疗效及对手术方式选择及效果的影响;另随机选取同期内30例行急诊手术患者作为对照组,比较两组患者一期吻合率、造瘘率及术后并发症等临床指标.结果 支架置入组从支架置入到手术切除的中位时间为9.7 d(1～20 d),70.0％手术以开腹进行,腹腔镜占25.0％,1例因年龄和并发症选择Hartmann手术.两组患者在围手术期死亡率(P=0.510)、术后总并发症(P=0.636)包括肺部感染、切口感染、炎性肠梗阻等方面比较,差异无统计学意义(均P>0.05).急诊手术组结肠造瘘率明显高于支架组(100.0％vs 5％,P<0.05),支架后手术组一期吻合率明显升高(95.0％vs 0％,P<0.05),腹腔镜手术率显著提高(25.0％vs 0％,P<0.05).结论 内镜联合X线下结肠金属支架置入能有效解除结肠癌引起的急性肠梗阻,避免急诊手术、增加一期吻合率、提高腹腔镜手术率、降低造瘘率.
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