标题：Ⅰ期切除吻合术在左半结肠癌合并急性肠梗阻患者中的应用

      作者：何锦生 1，蔡伟勤 1，姚玉玲 2    肇庆市端州区华佗医院外科 1、骨科 2，广东 肇庆 526040

      卷次： 2020年31卷15期

      【摘要】 目的 观察左半结肠癌合并急性肠梗阻患者行Ⅰ期切除吻合术治疗的效果。方法 选取2016年1月至2018年5月肇庆市端州区华佗医院收治的60例左半结肠癌合并急性肠梗阻患者为研究对象，根据随机数表法分为观察组和对照组各30例。观察组患者应用Ⅰ期切除吻合术，对照组应用分期切除吻合术，比较两组患者的手术和术后状况、术后并发症以及术后1年的生活质量。结果 观察组与对照组患者的手术时间[(3.58±0.62) h vs(5.41±0.97) h]、胃肠功能恢复时间[(3.35±0.88) d vs (5.61±1.34) d]、总住院时间[(17.42±2.34) d vs (28.62±2.64) d]比较，观察组明显短于对照组，差异均有统计学意义(P<0.05)；观察组和对照组患者术后并发症总发生率分别为13.33%、6.67%，差异无统计学意义(P>0.05)；观察组与对照组患者的心理功能[(64.15±5.57)分 vs (52.64±4.82)分]、社会功能[(68.04±5.05)分 vs (54.53±5.01)分]、物质生活[(66.03±6.14)分 vs (53.62±5.06)分]和躯体功能[(62.35±4.46)分vs (48.24±3.75)分]得分比较，观察组明显高于对照组，差异均有统计学意义(P<0.05)。结论 Ⅰ期切除吻合术治疗左半结肠癌合并急性肠梗阻能有效缩短患者手术和住院时间，提高患者生活质量，且安全性较高。
      【关键词】 结肠癌；肠梗阻；Ⅰ期切除吻合术；吻合口瘘；结肠；乙状结肠；疗效
      【中图分类号】 R735.3+5 【文献标识码】 A 【文章编号】 1003—6350（2020）15—1972—03

Application of one-stage resection and anastomosis in patients with left colon cancer complicated with acuteintestinal obstruction.
HE Jin-sheng 1, CAI Wei-qin 1, YAO Yu-ling 2. Department of Surgery 1, Department ofOrthopaedics 2, Duanzhou District Huatuo Hospital of Zhaoqing City, Zhaoqing 526040, Guangdong, CHINA
【Abstract】 Objective To observe the effect of one-stage resection and anastomosis in patients with left coloncancer complicated with acute intestinal obstruction. Methods A total of 60 patients with left colon cancer complicatedwith acute intestinal obstruction treated in Duanzhou District Huatuo Hospital of Zhaoqing City from January 2016 tomay 2018 were selected as the study objects. According to random number table, the patients were divided into the obser-vation group and the control group, with 30 patients in each group. The observation group was treated with one-stage resec-tion and anastomosis, and the control group was treated with staged resection and anastomosis. The surgical and postopera-tive conditions, postoperative complications, and quality of life 1 year after operation were compared between the twogroups. Results The operation time, gastrointestinal function recovery time, total hospitalization time in the observationgroup were significantly shorter than those in the control group (P<0.05): (3.58±0.62) h vs (5.41±0.97) h, (3.35±0.88) d vs(5.61±1.34) d, (17.42±2.34) d vs (28.62±2.64) d. There was no significant difference in the total incidence of postopera-tive complications between the observation group and the control group (13.33% vs 6.67%, P>0.05). The psychologicalfunction, social function, physical life, and physical function in the observation group were significantly higher than thosein the control group (P<0.05): (64.15±5.57) points vs (52.64±4.82) points, (68.04±5.05) points vs (54.53±5.01) points,(66.03±6.14) points vs (53.62±5.06) points, (62.35 ± 4.46) points vs (48.24±3.75) points. Conclusion One-stage resec-tion and anastomosis in the treatment of left colon cancer complicated with acute intestinal obstruction can effectivelyshorten the operation and hospitalization time, improve the quality of life of patients, and has high safety.
      【Key words】 Colon cancer; Intestinal obstruction; One-stage resection and anastomosis; Anastomotic leakage;Colon; Sigmoid colon; Curative effect