中西医结合治疗结肠癌的临床研究
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[摘要] 目的:评价中西医结合的方法治疗结肠癌梗阻的疗效。方法:将2005~2009年在我院治疗的结肠癌患者100例随机分为观察组和对照组。对照组行手术治疗,观察组根据梗阻性结肠癌的临床表现,采用禁食、胃肠减压、补液及经胃管投入药物治疗,有效缓解梗阻后再行手术治疗。结果:观察组总有效率为70.00%,优于对照组的总有效率50.00%(P<0.05)。两组均未见明显的不良反应。结论:利用中西医结合的方法能有效缓解结肠癌导致的梗阻,给切除吻合术创造手术条件和时机,还可减少术后再梗阻的可能,对提高手术切除率、减少并发症、降低死亡率有积极的意义。
[关键词] 结肠癌;梗阻;中西医结合
[中图分类号] R735.35[文献标识码]A [文章编号]1673-7210(2010)05(c)-037-02
Clinical research of Chinese and western medicine on the treatment of colon cancer
LEI Qiu′e
(Yongzhou Central Hospital of Hu′nan Province, Yongzhou425000, China)
[Abstract] Objective: To evaluate the effects of Chinese and western medicine on the treatment of colon cancer. Methods: 100 cases of patients with colon cancer were randomly divided into the observation group and control group from 2005 to 2009 in our hospital. Control group used surgical treatment; according to clinical manifestations of obstructive colon cancer, the observation group used fasting, gastrointestinal decompression, fluid replacement by stomach tube into drugs, then surgery after effectively alleviating obstruction. Results: The total effective rate of the observation group was 70.00%, was better than that of the control group (50.00%) (P<0.05); there was no significant adverse reaction between the two groups. Conclusion: Chinese and western medicine can effectively relieve obstruction caused by colon cancer, provide to the creation of surgical resection and anastomosis of the conditions and timing, and can reduce the possibility of postoperative obstruction, there is a positive significance to improve the resection rate, reduce complications and lower mortality rate.
[Key words] Colon cancer; Obstruction; Chinese and western medicine
结肠癌的临床表现多样,病情进展迅速,许多结肠癌患者到了出现肠梗阻时才来就诊,给治疗带来一定的困难。本文中笔者采用中西医结合的方法治疗部分结肠癌患者,取得较佳疗效,现报道如下:
1 资料与方法
1.1 一般资料
选择2005~2009年在我院治疗的结肠癌患者100例,年龄30～76岁,随机分为观察组和对照组两组。观察组中,男32例,女18例,年龄(56.1±4.7)岁;对照组中,男34例,女16例,年龄(55.8±3.9)岁。
1.2 方法
①对照组:行手术治疗。②观察组:根据梗阻性结肠癌的临床表现,在禁食、胃肠减压、灌肠、补液、维持水电解质平衡及应用抗生素的情况下,先抽空胃内容物,再经胃管注入25%甘露醇250 ml,2 h后注入全量甘遂黄硝汤或辨证加减的复方大承气汤,4 h后不见好转可重复1次,小儿和年老体弱者酌减,保守治疗12～24 h。症状未见缓解,即应急诊行手术治疗;不全梗阻者,除一般肠道准备外,亦用25%甘露醇250 ml口服;术后第2天起胃管注入胃肠复元汤水煎剂1/2剂;有效缓解梗阻后再行手术治疗。
1.3 效果评价
显效:术后肠功能恢复;有效:肠功能恢复,术后有并发症;无效:肠功能未得到恢复或死亡。
1.4 统计学处理
采用SPSS 12.0统计学软件处理。组间比较采用χ2检验,P<0.05表示差异有统计学意义。
2 结果
观察组总有效率为70.00%,优于对照组的总有效率50.00%,两组比较差异有统计学意义(P<0.05),见表1。两组均未见明显的不良反应。
表1 两组患者临床疗效比较[n(%)]
3 讨论
结肠癌是发生于结肠部位的常见的消化道恶性肿瘤,早期无明显症状,当发展至出血、感染或梗阻时才会出现症状,好发部位为直肠及直肠与乙状结肠交界处,而且其主要并发症是急性肠梗阻,发生率为8%～29%[1] ......
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