腹腔镜治疗结直肠癌的效果及对术后恢复的影响(1)
[摘要]目的 探讨腹腔镜和开腹治疗对结直肠癌临床效果和术后肠梗阻发生率的影响。方法 选取2013年2月～2016年2月在我院治疗的90例结直肠癌患者，按照患者意愿分为实验组60例和对照组30例，实验組采用腹腔镜治疗，对照组采用开腹治疗，比较两组患者术中情况(手术时间、术中出血量、切口长度)、术后疼痛评分和感觉良好率以及术后情况(肛门排气时间、下地活动时间、出院时间、肠梗阻发生率、并发症总发生率、复发转移率)。结果 术中实验组出血量和切口长度均显著小于对照组(P<0.05)，手术时间较对照组稍长，差异有统计学意义差(P<0.05)。实验组术后平均疼痛评分显著低于对照组(P<0.05)，感觉良好率显著高于对照组，差异有统计学意义(P<0.05)。术后实验组肛门排气时间、下地活动时间和出院时间均显著短于对照组(P<0.05)。实验组肠梗阻发生率、并发症总发生率、复发转移率均低于对照组，差异有统计学意义(P<0.05)。结论 腹腔镜治疗结直肠癌术中出血量更少，切口更小，肛门排气时间、下地活动时间和出院时间更短，且肠梗阻发生率、并发症总发生率、复发转移率更低，临床效果更佳，值得临床推广。
[关键词]腹腔镜；结直肠癌；肠梗阻
[中图分类号] R735.3 [文献标识码] A [文章编号] 1674-4721(2017)01(c)-0058-03
[Abstract]Objective To explore the clinical effect of laparoscopic and laparotomy in the treatment of colorectal cancer and influence on incidence rate of postoperative intestinal obstruction.Methods From February 2013 to February 2016，90 patients with colorectal cancer in our hospital were divided into experimental group(60 cases) and control group(30 cases) according to the patients′ willingness.Patients in the experimental group were treated by laparoscopic，patients in the control group were treated by laparotomy.Intraoperative conditions (operation time，intraoperative blood loss，length of incision)，postoperative pain score and feel good rate and postoperative conditions (anal exhaust time，ambulation time，discharge time，intestinal obstruction incidence rate，total complication rate，recurrence and metastasis rate) between two groups were compared.Results Intraoperative blood loss and length of incision in the experimental group was significantly less than that in the control group (P<0.05)，operation time was slightly longer than that in the control group，and the difference was statistically significant (P<0.05).Postoperative pain score in the experimental group was significantly lower than that in the control group (P<0.05)，feel good rate was significantly higher than that in the control group，and the difference was statistically significant (P<0.05).Postoperative anal exhaust time，ambulation time，discharge time in the experimental group was significantly shorter than that in the control group (P<0.05)，and intestinal obstruction incidence rate，total complication incidence，recurrence and metastasis rate was less than that in the control group，and the difference was statistically significant (P<0.05).Conclusion Laparoscopic in the treatment of colorectal cancer has less blood loss，smaller cut，shorter anal exhaust time，ambulation time and discharge time，lower intestinal obstruction incidence rate，total complication rate，recurrence and metastasis rate，and better clinical effect，witch is worth of promoting. (何志刚 何永忠 孔凡东 杜汉朋 吴铭键)
[关键词]腹腔镜；结直肠癌；肠梗阻
[中图分类号] R735.3 [文献标识码] A [文章编号] 1674-4721(2017)01(c)-0058-03
[Abstract]Objective To explore the clinical effect of laparoscopic and laparotomy in the treatment of colorectal cancer and influence on incidence rate of postoperative intestinal obstruction.Methods From February 2013 to February 2016，90 patients with colorectal cancer in our hospital were divided into experimental group(60 cases) and control group(30 cases) according to the patients′ willingness.Patients in the experimental group were treated by laparoscopic，patients in the control group were treated by laparotomy.Intraoperative conditions (operation time，intraoperative blood loss，length of incision)，postoperative pain score and feel good rate and postoperative conditions (anal exhaust time，ambulation time，discharge time，intestinal obstruction incidence rate，total complication rate，recurrence and metastasis rate) between two groups were compared.Results Intraoperative blood loss and length of incision in the experimental group was significantly less than that in the control group (P<0.05)，operation time was slightly longer than that in the control group，and the difference was statistically significant (P<0.05).Postoperative pain score in the experimental group was significantly lower than that in the control group (P<0.05)，feel good rate was significantly higher than that in the control group，and the difference was statistically significant (P<0.05).Postoperative anal exhaust time，ambulation time，discharge time in the experimental group was significantly shorter than that in the control group (P<0.05)，and intestinal obstruction incidence rate，total complication incidence，recurrence and metastasis rate was less than that in the control group，and the difference was statistically significant (P<0.05).Conclusion Laparoscopic in the treatment of colorectal cancer has less blood loss，smaller cut，shorter anal exhaust time，ambulation time and discharge time，lower intestinal obstruction incidence rate，total complication rate，recurrence and metastasis rate，and better clinical effect，witch is worth of promoting. (何志刚 何永忠 孔凡东 杜汉朋 吴铭键)