發(fā)布時間：2018-04-02 07:09

  本文選題：支架　切入點：內(nèi)鏡　出處：《浙江大學(xué)》2017年碩士論文

【摘要】：目的腸梗阻是結(jié)直腸癌患者最常見的急重并發(fā)癥之一,一旦發(fā)生,往往需要外科急診手術(shù)干預(yù),但急診手術(shù)的術(shù)后并發(fā)癥發(fā)生率和病死率較高。腸道支架的應(yīng)用,可以及時解除梗阻,恢復(fù)腸道功能,將急診手術(shù)轉(zhuǎn)變?yōu)楦踩膿衿谑中g(shù)。本研究旨在探討內(nèi)鏡下腸道支架置入術(shù)在結(jié)直腸癌性腸梗阻治療中的應(yīng)用效果,并分析比較支架置入后擇期手術(shù)與急診外科手術(shù)在左半結(jié)直腸癌腸梗阻治療中的臨床療效差別。方法收集2012年6月至2017年1月間因結(jié)直腸癌性腸梗阻于我院行內(nèi)鏡下腸道支架置入術(shù)治療的患者26例,回顧分析其臨床療效及并發(fā)癥情況。再選取其中支架置入后行擇期手術(shù)的左半結(jié)直腸癌腸梗阻患者14例作為研究組,另外選取同期于我院因左半結(jié)直腸癌腸梗阻行急診外科手術(shù)治療的患者19例作為對照組,比較這兩組接受不同治療方式患者的臨床療效及并發(fā)癥情況等。結(jié)果患者支架置入成功率100%(26/26),臨床癥狀緩解率96.15%(25/26),術(shù)后有1例(3.85%)患者出現(xiàn)穿孔,1例(3.85%)患者出現(xiàn)再梗阻,2例(7.69%)患者出現(xiàn)少量便血,所有患者無其他嚴重并發(fā)癥發(fā)生。研究組的一期手術(shù)率(50.00%vs.0 P=0.001)、造瘺率(57.14%vs.100%P=0.003)、腹腔鏡手術(shù)率(85.71%vs.0 P=0.000)、入 ICU 率(7.14%vs.52.63%,P=0.009)、術(shù)中出血量(P=0.002)要優(yōu)于對照組。而兩組患者在術(shù)后并發(fā)癥、首次住院時間及費用等方面沒有表現(xiàn)出明顯的差異(P0.05)。結(jié)論在結(jié)直腸癌腸梗阻治療中,腸道支架置入安全可靠,更加微創(chuàng),并發(fā)癥更少,在用于解除梗阻后擇期手術(shù)治療或姑息治療方面都有很大的優(yōu)勢。
[Abstract]:Objective intestinal obstruction is one of the most common acute and severe complications in patients with colorectal cancer.The application of intestinal stent can relieve obstruction in time, restore intestinal function, and transform emergency operation into safer elective operation.The purpose of this study was to investigate the efficacy of endoscopic intestinal stenting in the treatment of colorectal cancer intestinal obstruction, and to compare the clinical effects of selective and emergency surgery after stent implantation in the treatment of left colorectal cancer intestinal obstruction.Methods from June 2012 to January 2017, 26 patients with colorectal cancer intestinal obstruction underwent endoscopic stenting, and their clinical efficacy and complications were analyzed retrospectively.Among them, 14 patients with intestinal obstruction of left colorectal cancer who underwent elective operation after stent implantation were selected as study group, and 19 patients who underwent emergency surgical treatment for intestinal obstruction of left colorectal cancer in our hospital were selected as control group.The clinical efficacy and complications were compared between the two groups.Results the success rate of stent implantation was 100 / 26 / 26, the remission rate of clinical symptoms was 96.1525 / 26 / 26, and one patient with perforation was found to have perforation (1 case with 3. 85%) and 2 cases with recurrent obstruction (2 cases with 7. 69%) had a small amount of blood stool, and no other serious complications occurred in all the patients.In the study group, the rate of primary operation was 50.00vs.0, the rate of fistula was 57.14, the rate of laparoscopy was 85.71 and the rate of laparoscopy was 85.71vs.0P0.000, the rate of ICU was 7.14vs.52.63 and the volume of blood loss during operation was 0.002) was better than that of the control group.However, there was no significant difference in postoperative complications, first hospitalization time and cost between the two groups (P 0.05).Conclusion in the treatment of colorectal cancer intestinal obstruction, intestinal stent implantation is more safe and reliable, less invasive, less complications, and has great advantages in selective surgery or palliative treatment after relieving obstruction.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.34

【參考文獻】

相關(guān)期刊論文 前5條

1 Wanqing Chen;Rongshou Zheng;Siwei Zhang;Hongmei Zeng;Tingting Zuo;Changfa Xia;Zhixun Yang;Jie He;;Cancer incidence and mortality in China in 2013:an analysis based on urbanization level[J];Chinese Journal of Cancer Research;2017年01期

2 張s，

本文編號：1699309