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目的探讨术中肠道灌洗在梗阻性左半结肠癌根治术中肠道一期切除吻合的临床疗效。方法回顾性分析86例左半结肠癌并急性梗阻患者的术中处理。结果治疗组61例,行术中肠道灌洗一期切除吻合,56例恢复顺利,无并发症发生,5例出现伤口感染,3例出现吻合口瘘,2例死亡,均因晚期肿瘤致多器官衰竭死亡;对照组25例,行一期肠切除吻合而未行术中肠道灌洗,12例出现伤口感染,9例出现吻合口瘘,其中8例出现感染性休克,死于多器官功能衰竭(MODS)。统计显示术中肠道灌洗一期肠切除吻合组并发症发生率和死亡率明显低于未行结肠灌洗组,差异有统计学意义。结论左半结肠癌性梗阻术中肠道灌洗一期切除吻合对提高患者生存率,减少并发症发生有重要意义。
Objective To investigate the clinical efficacy of intraoperative intestinal lavage in the first stage of intestinal resection and anastomosis in the treatment of obstructive left-sided colon cancer. Methods Retrospective analysis of 86 cases of left colon cancer and acute obstruction in patients with intraoperative management. Results In the treatment group, 61 cases underwent intestinal resection and primary resection and anastomosis during the operation, 56 cases recovered smoothly, no complications occurred, 5 cases had wound infection, 3 cases had anastomotic fistula and 2 died. Multiple organ failure. In the control group, 25 cases underwent primary intestine resection and anastomosis but no intraoperative intestinal lavage. 12 cases had wound infection, and 9 cases had anastomotic fistula. Septic shock occurred in 8 cases and died of more Organ failure (MODS). Statistics show that intraoperative intestinal lavage an intestine resection anastomosis group complication rate and mortality was significantly lower than the group without colonic lavage, the difference was statistically significant. Conclusions The primary resection and anastomosis of intestine lavage in the treatment of left colon cancer with obstruction can improve the survival rate and reduce the incidence of complications.