作者：李伟

单位：武汉市红十字会医院 普通外科，湖北 武汉 430015

Authors:  Li Wei

Unit:  Wuhan RedCross hospital, Wuhan 430015, Hubei, China

摘要：

目的  探讨支架与肠梗阻导管治疗大肠癌合并肠梗阻的应用比较及血清二胺氧化酶(DAO)、丙二醛(MDA)水平的影响。方法  选取2016年5月～2018年1月收治的大肠癌合并肠梗阻患者70例,对照组采用经肛门肠梗阻导管治疗;观察组采用肠道支架植入术治疗,待肠梗阻缓解2周后进行腹腔镜手术。记录两组患者术中及术后相关指标,分别于术前、术后24 h及48 h时记录肠管直径及血清DAO、MDA水平,进行随访,记录并比较两组患者的术后并发症状况。结果  对照组肠道准备时间、出血量及腹痛腹胀缓解时间、术后活动时间(5.42±1.65、40.31±13.64、20.34±4.67)高于观察组(4.13±1.29、31.05±10.47、14.20±4.16),差异具有统计学意义(P<0.05)。对照组和观察组术后24 h肠管直径为(3.76±0.68)、(2.69±0.64) cm,术后24 h血DAO为(3.82±0.40)、(3.51±0.37), 术后24 h血MDA为(2.49±0.36) nmol/mL、(2.21±0.34) nmol/mL,术后48 h血DAO为(2.94±0.47)、(2.53±0.42),术后48 h血MDA为(2.23±0.27) nmol/mL、(2.03±0.21) nmol/mL,对照组和观察组上述指标比较,差异具有统计学意义(P<0.05)。两组患者肠梗阻现象均得到缓解,对照组和观察组死亡率、术后并发症发生率比较,差异无统计学意义(P>0.05)。结论  与肠梗阻导管比,支架在腹腔镜大肠癌合并肠梗阻患者术中损伤及术后恢复上更具优势,可降低血清DAO、MDA水平,术后恢复较快,值得推广。

关键词： 支架; 肠梗阻导管; 大肠癌合并肠梗阻

Abstract：

Objective  To investigate the effect of stent and intestinal obstruction catheter in laparoscopic surgery on clinical efficacy and serum DAO and MDA levels in patients with colorectal cancer complicated with intestinal obstruction. Methods  70 patients with colorectal cancer complicated with intestinal obstruction from May 2016 to January 2018 were selected.The control group received transanal intestinal obstruction catheter, the observation group received intestinal stent implantation and laparoscopic operation was performed after 2 weeks of intestinal obstruction relief. The intestinal diameter, blood DAO and MDA levels were recorded before operation, 24 hours after operation and 48 hours after operation. The postoperative complications were recorded and compared between the two groups. Results  The intestinal preparation time, bleeding volume, abdominal pain and distension relief time, postoperative activity time (5.42±1.65, 40.31±13.64, 20.34±4.67) in the control group were higher than those in the observation group (4.13±1.29, 31.05±10.47,14.20±4.16), the difference was statistically significant (P<0.05). The intestinal diameter of the control group and the observation group was (3.76±0.68), (2.69±0.64) cm 24 hours after operation, the serum DAO was (3.82±0.40), (3.51±0.37)24 hours after operation, the serum MDA was (2.49±0.36) nmol/mL, (2.21±0.34) nmol/mL 24 hours after operation, and the serum DAO was (2.94±0.47), (2.53±0.42 48 hours after operation. Nmol/mL, (2.03±0.21) nmol/mL, the control group and the observation group compared with the above indicators, the difference was statistically significant (P<0.05). There was no significant difference in mortality and postoperative complications between the control group and the observation group (P>0.05). Conclusion  Compared with intestinal obstruction catheter, stent has more advantages in the postoperative recovery and injury of patients with laparoscopic colorectal cancer complicated with intestinal obstruction. It can reduce the levels of serum DAO and MDA, and recover more quickly after operation. It is worth popularizing.

Key Words:  Stent;  Ileus catheter;  Colorectal cancer complicated with intestinal obstruction