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目的探讨急性梗阻性大肠癌局部联合静脉新辅助化疗法,解除肠梗阻同时达到限制肿瘤发展目的,避免急症手术。建立大肠癌并发急性肠梗阻一期根治的新方法方法对大肠癌并发急性肠梗阻病人16例(治疗组)进行前瞻性观察。随机选取同类疾病接受单一静脉化疗病人10例(对照组),急症肠造口术病人10例(空白组)作对照。选择标准评估值进行比较。结果治疗组病人在48~72h肠梗阻全部缓解,并能饮食,体重平均增长3.5 kg。与对照组和空白组比较,差异有统计学意义(P〈0.001)。C-反应蛋白下降平均值16.8 mg/L.血清CEA下降平均值5μg/L,血红蛋白增长平均值17.8g/L,周围静脉血CD4’增长平均值3.16%与对照组和空白组比较,差异有统计学意义(P〈0.05)。结论急性梗阻性大肠癌局部联合静脉新辅助化疗能有效缓解肠梗阻症状,规避急症手术带来的机体免疫力下降,电解质紊乱,营养障碍,吻合口瘘等危险该方法在解除肠梗阻同时,达到限制原发和转移癌生长的目的,为急性梗阻性大肠癌一期根治切除创造条件
Objective To investigate the local combined with neoadjuvant chemotherapy for acute obstructive colorectal cancer to relieve the intestinal obstruction and to limit the development of the tumor at the same time and avoid the emergency surgery. Establishment of a new method of colorectal cancer complicated with acute intestinal obstruction in the first phase method of colorectal cancer patients with acute intestinal obstruction in 16 cases (treatment group) were prospectively observed. Ten patients (control group) receiving single intravenous chemotherapy and 10 patients with acute enterostomy (blank group) were selected randomly as the control. Select the standard evaluation value for comparison. Results The patients in the treatment group were relieved of intestinal obstruction at 48 ~ 72h, and were able to diet and gain an average weight gain of 3.5 kg. Compared with the control group and the blank group, the difference was statistically significant (P <0.001). C-reactive protein decreased average 16.8 mg / L. Serum CEA decreased average 5μg / L, hemoglobin increased by 17.8g / L, peripheral venous blood CD4 ’increased by 3.16% compared with the control group and the blank group, the difference was Statistical significance (P <0.05). Conclusion Local anesthesia with adjuvant intravenous neoadjuvant chemotherapy for acute obstructive colorectal cancer can effectively relieve the symptoms of intestinal obstruction and avoid the decrease of immunity, electrolyte imbalance, nutritional disorders and anastomotic fistula caused by emergency surgery. The method can relieve intestinal obstruction and achieve Limit primary and metastatic cancer growth for the purpose of radical resection of acute obstructive colorectal cancer to create a condition