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目的探讨经胃肠梗阻导管排列小肠造口术在治疗转移性恶性肠梗阻中的应用价值。方法对符合入组标准的12例转移性恶性肠梗阻患者采用肠梗阻导管经胃戳口进行排列小肠并造口,观察围手术期效果,术后随访梗阻缓解情况及生存时间。结果 12例患者均完成手术,手术顺利,手术时间90~120 min(平均113.6min);胃肠功能恢复时间为2~5 d,中位时间2.8 d;住院时间为9~32 d,中位住院时间18.4 d;围手术期死亡1例。11例进行随访,随访时间3~36个月(平均19.6个月),生存时间3~36个月,中位生存期14.8个月,受益缓解率为91.7%(11/12)。结论合理选择应用经胃肠梗阻导管排列小肠造口术,可使部分患者解除梗阻,经口进食,同时延缓再次梗阻的时间,延长生存期。
Objective To investigate the application of small bowel colostomy by gastrointestinal obstruction in the treatment of metastatic malignant intestinal obstruction. Methods A total of 12 patients with metastatic malignant intestinal obstruction conforming to the inclusion criteria were enrolled in the small intestine and stoma by intestinal obstruction. The effects of perioperative period, postoperative follow-up of obstructive remission and survival time were observed. Results All the 12 patients underwent surgery successfully. The operation time ranged from 90 to 120 min (average 113.6 min). The gastrointestinal function recovery time was 2 to 5 days, median time was 2.8 days. The length of stay was 9 to 32 days The hospitalization time was 18.4 days. Perioperative death was found in 1 case. Eleven patients were followed up for 3 to 36 months (mean, 19.6 months). The survival time ranged from 3 to 36 months. The median survival time was 14.8 months. The benefit-remission rate was 91.7% (11/12). Conclusion The reasonable choice of the application of gastrointestinal obstruction catheterization colostomy, can make some patients relieve obstruction, oral intake, while prolonging the time of re-obstruction and prolong survival.