【摘要】 目的 比较支架植入后不同时期行腹腔镜手术治疗老年梗阻性结直肠癌患者的临床疗效。方法 根据支架植入后腹腔镜手术时间的不同将76例老年梗阻性结直肠癌患者分为对照组(n=38,支架植入治疗12天后实施腹腔镜手术)和观察组(n=38,支架植入治疗2～6天后实施腹腔镜手术)。比较两组患者的手术相关指标、应激反应指标[血糖和C反应蛋白(CRP)]、生活质量[生活质量综合评定问卷(GQOL-74)]、并发症发生情况及生存情况。结果 观察组患者住院时间、首次进流食时间、首次排便时间、首次排气时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血糖、CRP水平均高于本组治疗前,观察组患者血糖、CRP水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者GQOL-74各维度评分均高于本组治疗前,观察组患者GQOL-74各维度评分均高于对照组,差异有统计学意义(P<0.95)。观察组患者的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。两组患者的6个月生存率比较,差异无统计学意义(P>0.05)。结论 对于老年梗阻性结直肠癌患者,支架植入治疗2～6天后实施腹腔镜手术有利于患者术后恢复,降低术后并发症发生率,减轻应激反应,提高生活质量。更多还原

【Abstract】 Objective To compare the clinical efficacy of laparoscopic surgery in the treatment of elderly patients with obstructive colorectal cancer at different periods after stent implantation.Method According to the different laparoscopic surgery time after stent implantation,76 elderly patients with obstructive colorectal cancer were divided into control group(n=38,laparoscopic surgery was performed 12 days after stent implantation) and observation group(n=38,laparoscopic surgery was performed 2-6 days after stent implantation).The surgery-related indexes,stress response indexes[blood glucose and C-reactive protein(CRP)],quality of life [generic quality of life inventory-74(GQOL-74)],incidence of complications and survival were compared between the two groups.Result The hospitalization time,first liquid feeding time,first defecation time and first exhaust time in observation group were shorter than those in control group,and the differences were statistically significant(P<0.05).After treatment,the blood glucose and CRP levels in both groups were higher than those before treatment,and the blood glucose and CRP levels in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).After treatment,the scores of each dimension of GQOL-74 in both groups were higher than those before treatment,and the scores of each dimension of GQOL-74 in observation group were higher than those in control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in 6-month survival rate between the two groups(P>0.05).Conclusion For elderly patients with obstructive colorectal cancer,laparoscopic surgery 2-6 days after stent implantation is conducive to postoperative recovery,reducing the incidence of postoperative complications,alleviating stress reaction,and improving quality of life.更多还原