ABSTRACT
Objective:To investigate the incidence of adhesive intestinal obstruction after resection of colon cancer and analyze its risk factors.Methods:Three hundred and sixty-three colon cancer patients who underwent colon cancer resection in Affiliated Hospital of Weifang Medical University from March 2016 to September 2019 were selected as the research objects, including 189 male and 174 female, aged from 45 to 75 years old, with the average of (62.36±10.69) years. Postoperative outpatient follow-up for 6 months to record the incidence of adhesive intestinal obstruction in patients after colon cancer resection. According to the occurrence of adhesive intestinal obstruction, they were divided into occurrence group and non-occurring group. The general data, laboratory data and pathological data of the two groups of patients were compared. Logistic regression was used to analyze the risk factors of adhesive intestinal obstruction after colon cancer resection.Results:As of the last follow-up time on March 23, 2020, a total of 13 patients were lost to follow-up due to different reasons. A total of 350 patients completed the follow-up, and 350 patients were finally included. The incidence of adhesive intestinal obstruction after colon cancer resection was 22.29% (78/350), these 78 patients were defined as the occurrence group, and the other 272 patients without adhesive intestinal obstruction were regarded as the non-occurrence group. There were statistically significant differences in age, comorbid diabetes, surgical methods, operation time, tumor differentiation, and lymphatic metastasis between the occurrence group and the non-occurring group ( χ2=275.397, P<0.001; χ2=52.574, P<0.001; χ2=137.931, P<0.001; χ2=48.419, P<0.001; χ2=2.099, P=0.036; χ2=36.073, P<0.001); multivariate logistic regression analysis showed that age>60 years old ( OR=41.113), complicated with diabetes ( OR=0.055), open surgery ( OR=21.913), long operation time ( OR=25.069), high degree of tumor differentiation ( OR=0.109), lymphatic metastasis ( OR=0.068) are the adhesive bowel after colon cancer resection Risk factors for obstruction. Conclusions:The incidence of bowel function after colon cancer resection was 22.29%. Age, operation method, operation time, comorbidities, tumor differentiation degree, and lymphatic metastasis are the influencing factors of adhesive intestinal obstruction after colon cancer resection, and should be treated in the treatment process. Focus on preventing the occurrence of adhesive intestinal obstruction after colon cancer resection.
ABSTRACT
Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg·kg -1 ·h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate(HR)and mean arterial pres-sure(MAP)of the two groups were compared when entered into surgery room(T0 ),administered 5min(T1 ),after intubation(T2 ),surgical incision(T3 )and after extubation(T4 ),and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were (62.2 ± 1.1)times/min,(67.3 ±3.2)times/min,(69.2 ±2.3)times/min,(70.2 ±2.5)beats/min and(68.3 ±0.5)mmHg,(70.1 ±0.9)mmHg,(71.5 ±0.9)mmHg,(68.2 ±1.9)mmHg significantly lower than which of the control group (t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P <0.05),and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant(t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P <0.05);Compose score(4.2 ±1.3)points of the study group was significantly higher than (1.2 ±0.2)points of the control group,but the agitation score of the study group was(1.2 ±0.7)points,which was significantly lower than (2.9 ±1.5)points of the control group,the differences were statistically significant(t =9.38,8.379,all P <0.05).Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.