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目的 :探讨大肠癌并急性肠梗阻的手术方式及预防吻合口瘘的措施。方法 :回顾性分析经手术治疗的大肠癌并急性肠梗阻 6 3例。结果 :一期切除吻合率 79 4 % (5 0 /6 3) ,吻合口瘘发生率 4 % (2 /5 0 ) ,切口感染率 6 % (3/5 0 ) ;单纯造瘘 6例 ,其中术后切口裂开 1例 ;一期切除二期吻合及捷径手术共 7例 ,无近期并发症发生。结论 :术式选择、术中肠腔减压和结肠灌洗、术后抗感染以及胃肠外营养等均是手术治疗大肠癌并肠梗阻的关键。
Objective: To explore the surgical methods for colorectal cancer and acute intestinal obstruction and the measures to prevent anastomotic leakage. Methods : Retrospective analysis of surgically treated colorectal cancer and acute intestinal obstruction in 63 cases. Results: One-stage resection and anastomosis rate was 79.4% (50/63), the incidence of anastomotic leakage was 4% (2/5), the incision infection rate was 6 % (3/5 0), and 6 cases were simple hernias. Among them, 1 case had a dehiscence after incision; 7 cases had one-stage resection of two-stage anastomosis and shortcut surgery, and no recent complications occurred. Conclusion :Surgery selection, intra-operative decompression and colon lavage, postoperative anti-infection and parenteral nutrition are the key to surgical treatment of colorectal cancer and intestinal obstruction.