大肠癌致急性肠梗阻的外科治疗(附84例临床分析) (pdf)

    【摘要】 目的 探讨大肠癌致急性肠梗阻的外科治疗原则及预后。方法 回顾性分析84例大肠癌致急性肠梗阻的外科治疗临床资料，其中右半结肠癌9例，左半结肠癌30例，直肠癌45例。84例中Dukes B期12例，C期40例，D期32例。84例均手术治疗，其中行结肠造口9例，miles手术32例， Hartmann手术9例，一期切除吻合加肠外置术6例，结肠灌洗一期切除吻合28例。结果 治愈82例，死亡2例。未能切除癌肿的2例患者术后5个月死亡。结论 手术治疗是解除大肠癌致急性肠梗阻的唯一方法。应根据患者的年龄、体质、腹腔污染等情况选择合理的手术方式。

    【关键词】 大肠癌；急性肠梗阻；外科治疗

    Surgical treatmeant of acute intestinal obstruction caused by colorectal carcinoma:analysis of 84 cases

    ZHANG Dong-ping，YANG De-lan.The General Surgery of the First People's Hospital of Jingzhou City,Hubei 434007,China

    【Abstract】 Objective This study was designed to explore the principle of surgical treatment and the prognosis of acute intestinal obstruction complicated with colorectal carcinoma. Methods The clinical data of acute intestinal obstruction caused by colorectal carcinoma of 84 cases were retrospectively analyzed. In the 84 cases, right hemicolonic cancer occurred in 9 cases, left hemicolonic cancer in 30 cases and rectal cancer in 45 cases. Of the 84 patients, 12 cases were classified as Ducks B stage, 40 C stage, and 32 D stage. All these 84 cases underwent surgical treatment, of which 9 cases were subjected to colostomy, 32 to Miles’ operation, 9 to Hartmann’s operation. 6 to primary resection and anastomosis plus intestinal exteriorization and 28 to primary resection and anastomosis plus colonic lavage. Results 82 cases were cured and 2 died. The 2 cases from failure in resection died in five months later after operation. Conclusion Surgical operation is the only mean for acute intestinal obstruction complicated with colorectal carcinoma, and should properly be performed according to such factors as the patient’s age, constitution, abdominal contamination, etc. ......