分析左半结肠切除一期吻合加回肠末端造瘘治疗老年梗阻性左半结肠癌的临床效果。

回顾性分析2014年1月至2017年6月80例行左半结肠切除一期吻合术患者的临床资料，根据左半结肠切除一期吻合术后是否加行回肠末端造瘘手术分为研究组(加行回肠末端造瘘手术，39例)和对照组(未加行回肠末端造瘘手术，41例)。数据采用SPSS 20.0统计软件进行分析，患者术中术后各项指标以(±s)表示，组间比较采用独立t检验。术后并发症的发生情况采用χ²检验。以P<0.05表示差异具有统计学意义。

两组患者术中出血量相比，差异无统计学意义(P>0.05)；研究组患者手术时间较对照组显著延长(P<0.05)；研究组患者术后首次排气时间、首次进食时间、引流管拔出时间以及住院时间分别为(2.5±0.9) d、 (2.5±0.7) d、 (5.7±1.5) d、 (14.3±1.8) d，较对照组均显著缩短，差异具有统计学意义(P<0.05)。研究组吻合口漏及总并发症发生率分别为2.6%、17.9%，显著低于对照组(17.1%、41.5%)，差异具有统计学意义(P<0.05)。两组患者术后存活率分别为92.3%、 90.2%，差异无统计学意义(P>0.05)。

左半结肠切除一期吻合联合回肠末端造瘘，可促进梗阻性左半结肠癌患者进术后恢复，缩短住院时间，减少术后并发症，值得在临床推广使用。

To analyze the clinical effect of loop ileostomy after left hemicolectomy combine with one-stage anastomosis for the elderly patients with obstructing left-sided colonic cancer.

A retrospective analysis of 80 cases of obstructing left-sided colonic cancer patients undergoing left hemicolectomy in our hospital from January 2014 to June 2017 was made. According to whether undergoing loop ileostomy after resection, the patients were divided into the study group (with loop ileostomy, 39 cases) and control group (without loop ileostomy, 41 cases). All data were analyzed by SPSS 20.0 statistical software. The intraoperative and postoperative related indicators were presented as (±s) and were compared by t test. The incidence of postoperative complications was examined by chi square test.

There was no statistical difference in the intraoperative blood loss between the two groups (P>0.05). The operation time in the study group was significantly longer than that in the control group (P<0.05). The postoperative first feeding time, first exhaust time, drainage time, length of stay in the study group respectively were (2.5±0.9) d, (2.5±0.7) d, (5.7±1.5) d, (14.3±1.8) d, which were significantly shorter than those in the control group, all above had statistical difference (P<0.05). The rate of anastomotic leakage and totally postoperative complications in the study group was 2.6%, 17.9% respectively, which were significantly lower than those in the control group, 17.1%, 41.5%, all above had statistical difference (P<0.05).

The loop ileostomy after left hemicolectomy combine with one-stage anastomosis could promote postoperative recovery, shorten the length of stay and reduce postoperative complications, which is worthy of clinical promotion.