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JAMA SURG：恶性大肠梗阻姑息性支架术与造口术术后效果对比

2017-05-23 MedSci MedSci原创

恶性大肠梗阻支架术造口术
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结肠支架术作为恶性大肠梗阻（MLBO）姑息性手术治疗的方式之一已应用超过20年，但是仍然存在一些争议。JAMA SURG上近期发表了一篇文章，比较需要急诊治疗的MLBO患者姑息性支架术与造口的术术后效果。

结肠支架术作为恶性大肠梗阻（MLBO）姑息性手术治疗的方式之一已应用超过20年，但是仍然存在一些争议。JAMA SURG上近期发表了一篇文章，比较需要急诊治疗的MLBO患者姑息性支架术与造口的术术后效果。

研究共纳入2009年10月1日至2013年13月31日345例继发于结直肠癌需要急诊处理的肠梗阻患者，这些患者接受支架术或造口术。1年内接受肿瘤切除的患者不纳入此研究。主要的研究结果包括90天及1年随访期内后续手术及再入院情况。次要研究结果为院内死亡、主要并发症、住院时间、花费及出院情况。造口组平均年龄69.9岁，支架组70.9岁。造口组男性87例，支架组90例。造口组非西班牙裔白人患者114例，支架组90例。104例患者在大医院接受手术，42例在中等医院接受手术，26例在小医院接受手术。接受支架术的患者住院时间更短，与造口组相比，术后并发症相似或更少。在90天及1年再入院方面两组无显着差异。两组间90天后续手术无差异，但是支架组1年内后续手术的可能性更高，其中最多的手术是再次支架。

文章最后认为，对于MLBO患者，如果肿瘤切除无法达到的话，支架术是一项安全并且可以显着改善患者生活质量的手术方式。应在经验丰富的医疗中心进行支架术，由于1年内存在再次支架的风险，应对患者进行告知。

原始出处：
Jonathan S.Abelson,Heather L.Yeo,et al.Long-term Postprocedural Outcomes of Palliative Emergence Stenting vs Stoma in Malignant Large-Bowel Obstruction.JAMA SURG.May 2017 doi:10.1001/jamasurg.2016.5043

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    2017-07-24 qindq

    #支架术#

    0

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    2017-05-25 hjwang79

    #肠梗阻#

    0

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    2017-05-25 wjcjjian

    #造口术#

    0

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    2017-05-25 经常头晕

    #姑息#

    0

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    2017-05-23 榄枷檬

    谢谢分享

    0