氩氦刀低温冷冻治疗肛管直肠癌的临床分析

雷斌1，刘会侠2，李文鹏1，贾冰心1，余伟1，高怀军1

（1.榆林市中医院北方医院肿瘤微创外科，陕西 榆林，719000；2.杨凌示范区医院，陕西 杨凌，712100）

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摘要：

目的 探讨氩氦刀低温冷冻治疗晚期肛管直肠癌的临床疗效。方法 回顾性分析2011年3月至2013年3月在我院接受氩氦刀低温冷冻治疗的肛管直肠癌患者33例（氩氦刀组）及接受传统直肠癌手术治疗的患者29例（对照组）的临床资料，比较两组患者的手术时间、术中出血量、住院时间，并观察两组患者术后排气、腹胀、疼痛情况及生存率。结果 氩氦刀组患者的手术时间、术中出血量及住院时间优于对照组（P<0.05）；氩氦刀组肛门后排气时间、腹胀及疼痛缓解时间明显优于对照组，差异有统计学意义（P<0.05），两组2年生存率比较，差异无统计学意义（P>0.05）。结论 对晚期肛管直肠癌患者应用氩氦刀低温冷冻术治疗可以获得优于开腹手术治疗的临床效果，且操作简单，便于掌握，不良反应轻微，创伤小，出血少，恢复快，避免了人工肛门的不便，明显提高了患者的生存质量。

关键词：氩氦刀；低温冷冻；肛管直肠癌

中图分类号：R735.3文献标志码：A文章编号：2096-1413(2017)13-0075-02

Analysis of argon-helium knife cryogenics in the treatment of anal canal rectum cancer
LEI Bin 1, LIU Hui-xia 2, LI Wen-peng 1, JIA Bing-xin 1, YU Wei 1, GAO Huai-jun 1
(1. Department of Tumor Minimally Invasive Surgery, North Hospital of Traditional Chinese Medicine Hospital of Yulin, Yulin 719000; 2. Yangling District Hospital, Yangling 712100, China)

ABSTRACT: Objective To investigate the curative effect of argon -helium knife cryogenics on canal rectum cancer. Methods The clinical data of 62 cases of patients with rectal cancer in our hospital from March 2011 to March 2013 were retrospectively analyzed, and 33 cases were treated with argon-helium knife cryogenics were chosen as the argon-helium knife group, and 29 patients recieved traditional surgery were selected as the control group, the operation time, intraoperative blood loss, hospital stay, exhaust time, abdominal distension, pain occurring and survival rate were observed in the two groups. Results The operation time, intraoperative blood loss and length of hospital stay in the argon-helium knife group were better than those in the control group (P<0.05); the postoperative exhaust time, abdominal and pain remission time of the argon-helium knife group were statistically better than those of the control group (P<0.05); there was no significant difference of the survival rate in the two groups for 2 years (P>0.05). Conclusion Argon-helium knife cryogenics has a better effect than traditional operation on canal rectum cancer, which has many advantage such as easy operation, mild adverse reaction, small trauma, less bleeding, and fast recovery. It can avoid the inconvenience of artificial anal, improve the survival quality.

KEYWORDS: argon-helium knife; cryogenics; canal rectum cancer

参考文献：
[1] 吴在德,吴肇汉.外科学[M].7 版.北京:人民卫生出版社,2008:493.
[2] SCHFERH,BALDUS SE,HOLSCHER AH.Giant adenomas of the rectum:complete resection by transanal endoscopic microsurgery (TEM) [J].Int J Cororectal Dis,2006,21(6):458-460.
[3] EDGE SB,BYRD DR,COMPTON CC.AJCC cancer staging manual [M].7th.New York:Springer,2010.
[4] 王洪武,贺声.经皮穿刺氩氦刀治疗肝癌[J].中国肿瘤临床与康复,2005,12(1):30-33.
[5] 闻炳基,李海兵,花金年,等.氩氦刀冷冻时间与冰球大小的临床研究[J].肿瘤学杂志,2005,11(6):458-460.
[6] 王伦长,涂汉学,秦军.临床冷冻学[M].郑州:河南科技出版社,2005:198-203.
[7] 史倩.氩氦刀冷冻消融治疗45 例中晚期恶性肿瘤临床疗效观察 [D].北京:北京中医药大学,2016:36-37.