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目的:对结肠癌并发肠梗阻老年患者的围手术期进行临床分析研究,观察手术治疗方式及效果。方法:从2013年3月到2014年2月于我院治疗的结肠癌并发肠梗阻病例中选取30例老年患者,所有患者均给予术前准备、术后并发症防治及围术期营养支持,随机分为采用腹腔镜手术治疗的观察组(15例)及常规开腹术治疗的对照组(15例),对各组围手术期进行观察分析。结果:采用腹腔镜手术治疗的15例观察组患者中无死亡病例,存活率100%,对照组1例术中死亡,存活率93.33%,两组存活率存在差异显著(p<0.05),此外观察组手术时间、住院时间数据均低于对照组(p均<0.05),其中对照组共5例并发症病例,分别为切口感染2例,吻合口瘘1例,下肢静脉血栓1例,肺部感染1例,观察组1例肺部感染,两组术后并发症发生率存在明显差异(p<0.05)。结论:对老年结肠癌并发肠梗阻患者进行手术治疗的疗效确切,同时术后并发症防治及围术期营养支持也是辅助治疗的关键,其中采用腹腔镜手术治疗包括术中治疗时间、术后恢复时间及术后并发症几率等在内的治疗效果均明显好于常规开腹术治疗,值得推广。
Objective: To study the clinical analysis of perioperative period of elderly patients with colon obstruction and intestinal obstruction and to observe the surgical treatment and effect. Methods: From March 2013 to February 2014, 30 elderly patients were enrolled in our study. All patients were given preoperative preparation, postoperative complications prevention and perioperative nutritional support, All patients were randomly divided into observation group (15 cases) treated with laparoscopic surgery and control group (15 cases) treated with conventional laparotomy. Perioperative period was observed and analyzed. Results: There were no deaths in the observation group of 15 cases treated with laparoscopic surgery, the survival rate was 100%. One case died in the control group, the survival rate was 93.33%. There was significant difference (p <0.05) in survival rate between the two groups The data of operation time and hospital stay in the observation group were lower than those in the control group (all p <0.05). There were 5 cases of complications in the control group, including 2 cases of incision infection, 1 case of anastomotic fistula, 1 case of venous thrombosis of the lower extremity, 1 case of infection and 1 case of lung infection in the observation group. There was significant difference in the incidence of postoperative complications between the two groups (p <0.05). Conclusion: Surgical treatment of elderly patients with colon obstruction with intestinal obstruction is effective, and the prevention and treatment of postoperative complications and perioperative nutritional support are also the key to adjuvant therapy. Among them, laparoscopic surgery including intraoperative treatment time, postoperative recovery Time and postoperative complications such as the probability of treatment are significantly better than conventional open surgery, it is worth promoting.