| 摘要: |
| 目的 探讨小肠减压管在腹腔镜右半结肠癌并梗阻患者围手术期的应用价值。 方法 收集2012年12月至2018年12月于广西壮族自治区人民医院普外科因右半结肠癌并梗阻行手术治疗的76例患者,将其分为术前经小肠减压管减压后限期施行腹腔镜右半结肠癌根治术的研究组患者30例和入院后急诊行开腹右半结肠癌根治术的对照组患者46例,比较两组患者的术前血清白蛋白水平、术前电解质情况、平均手术时间、术中出血量、淋巴结清扫数量、术后3天平均引流量、术后肛门排气时间、术后并发症情况、住院总天数、住院总费用。 结果 经放置小肠减压管再限期行腹腔镜右半结肠癌根治术组较急诊手术组,术前低蛋白血症及电解质紊乱情况改善得更好,手术时间明显缩短(183.3±21.1 min vs 222.7±25.7 min,P<0.05)、术中出血量减少(105.5±34.3ml vs 226.2±64.7ml,P<0.05)、淋巴结清扫数量增加(21.9±3.8枚 vs 20.1±2.9枚,P<0.05)、术后3天平均引流量较少(112.3±44.6ml vs 170.5±46.0ml,P<0.05),术后肛门排气时间缩短(2.4±1.0d vs 4.2±0.9d,P<0.05),住院总天数、住院总费用两组无统计学差异。 结论 对于右半结肠癌并梗阻的患者,术前应用小肠减压管进行胃肠减压,有助于减轻患者术前腹胀症状,为纠正患者术前的机体失衡状态争取时间,并且能为腹腔镜微创手术创造条件,手术时间更短、术中出血更少、清扫淋巴结数量更多、术后恢复更快,并未增加住院时间及费用。 |
| 关键词: 小肠减压管 右半结肠癌 肠梗阻 围手术期 |
| DOI： |
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| Application of Intestinal Decompression Tube in Laparoscopic Obstructive Right-Sided Colon Cancer during Perioperative Period |
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Liu Chao
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the People’s Hospital of Guangxi Zhuang Autonomous Region
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| Abstract: |
| Objective To study the value of intestinal decompression tube in laparoscopic obstructive right-sided colon cancer during perioperative period. Methods 76 obstructive right-sided colon cancer patients who received surgery between December 2012 and December 2018 in the department of general surgery of the People’s Hospital of Guangxi Zhuang Autonomous Region were included in this study. We divided the patients into the study group who performed laparoscopic surgery preoperatively with a intestine decompression tube(n=30) and the control group who performed emergency laparotomy(n=46).The preoperative serum albumin levels, preoperative electrolyte status, average operation time, blood loss, number of harvested lymph nodes, average drainage at 3 days after surgery, postoperative anal exhaust time, postoperative complications, hospital stay and the hospital costs were compared between the two groups. Results Preoperative hypoproteinemia and electrolyte disturbance were better improved in the study group. Average operation time(183.3±21.1 minutes vs 222.7±25.7 minutes,P<0.05)was significantly shorter, blood loss(105.5±34.3ml vs 226.2±64.7ml,P<0.05)was significantly less, the number of harvested lymph nodes(21.9±3.8 vs 20.1±2.9,P<0.05)was significantly increased, average drainage at 3 days after surgery(112.3±44.6ml vs 170.5±46.0ml,P<0.05)was significantly less,postoperative anal exhaust time(2.4±1.0days vs 4.2±0.9days,P<0.05)was significantly shorter in the study group who performed laparoscopic surgery preoperatively with a intestinal decompression tube. The hospital stay and the hospital costs were not significantly different between the two groups. Conclusions Application for obstructive right-sided colon cancer patients, preoperative intestinal decompression tube could alleviate the abdominal distension symptoms and buy time to correct the body imbalance before surgery. It could also create conditions for laparoscopic minimally invasive surgery, shorten the operation time, reduce intraoperative bleeding, increase the number of harvested lymph nodes, and accelerate postoperative recovery. However, there was no increase in hospital stays or costs. |
| Key words: Intestinal decompression tube Right-sided colon cancer Intestinal obstruction Perioperative period |
